Palliative operations were performed on seven patients with pulmonary atresia which was associated with intact ventricular septum (2), large ventricular septal defect (3), and asplenia syndrome (2). Although the infants with intact ventricular septum survived the Brock operation and symptomatically improved remarkably, the right ventricular pressure still remained high for approximately one year postoperatively requiring corrective surgery in the near future in both cases. In the group of pulmonary atresia with large ventricular septal defect and large aortopulmonary collateral arteries providing all of the pulmonary blood flow, the operative methods should be determined by the precise preoperative findings of the true pulmonary arteries. These arteries should be examined with selective angiography of all the aortopulmonay collateral arteries and by wedge angiography of the pulmonary vein. Operative results for pulmonary atresia with asplenia syndrome were unsatisfactory due to association with total anomalous pulmonary venous drainage (TAPVD). In such cases, intraoperative interventions are necessary to verify the association of TAPVD. Anastomosis between the common pulmonary vein and the common atrium should be performed concomitantly if the association with TAPVD is confirmed.
