The surgical anatomy of hypoplasia of aortic tract complex.

The surgical anatomy of 230 hearts with hypoplasia of the aortic tract complex or the hypoplastic left heart syndrome is described in detail. Recent work has indicated that this may be an operable entity. There were 105 hearts with aortic atresia and mitral stenosis, 95 hearts with aortic and mitral atresia, and 30 hearts with severe aortic and mitral stenosis. Special emphasis is given to the right atrium, right ventricle, and sizes of the ascending and transverse aorta. Attention is called to the pathological changes in the tricuspid orifice and valve and in the ventricular septum. It was of interest that many of the hearts had only a patent foramen ovale rather than a distinct atrial septal defect. In addition, the atrial septum was abnormally formed. The anatomic data presented may be of surgical import. Hypoplasia of the aortic tract complexes may be variations of premature narrowing of foramen ovale.