Severe right ventricular failure after Mustard or Senning operation. Two-stage repair: pulmonary artery banding and switch.

Since early 1981 I have been banding the pulmonary arteries of patients in whom severe right ventricular dysfunction has developed after atrial repair of transposition of the great arteries. The purpose of banding is to "retrain" the left ventricle. Of the four patients so treated, two developed adequate left ventricular pressures and have successfully undergone an arterial switch and takedown of the atrial repair. The early results are impressive. Right ventricular function has returned to normal in both patients and tricuspid valve regurgitation has resolved. In one patient moderate aortic valve regurgitation also appears to have largely resolved.