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KMID : 0378019710140100053
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New Medical Journal
1971 Volume.14 No. 10 p.53 ~ p.71
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Waterston´s Operation
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Abstract
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A histologic study of the lung was done in 28 dogs after Waterston´s operation. The diameter of anastomosis stoma was about 5mm.
Out of ten dogs expired after operation 3 cases were due to acute intractable cardiac failure in spite of digitalization.
Fourteen long-term survivors and 4 short term survivors were obtained.
One, two, three, four, and six months postoperative long term survivors were sacrificed after auscultation and aortography.
A large bore polyethylene catheter was inserted into the left ventricular cavity through the apex and 20 to 40 cc of 80% iodine dye was injected manually.
The following observatins were made.
(A) Auscultation of the chest
In every survivors continuous machinery murmur was auscultated, showing patency of the aorticopul￢monary shunt operation stoma.
B. Pulmonary arteriography by left ventricular dye injection showed simultaneous opacification of the bilateral pulmonary arteries with the aorta in every case, which shows patency of the anastomosis stoma. Pulmonary artery dilation extended into the peripheral branches.
C. Histological findindings
In lung parenchym, congestion, alveolar dilatation, alveolar rupture, alveolar wall thickening, and capillary formation were noted in the one month specimens.
The above mentioned findings increased in intensity among two months group, after which the findings were rather stable, showing little changes.
Pulmonary vascular changes were characterized by intimal proliferation, medial hypertrophy and
connective tissue proliferation in the adventitia.
In pulmonary arterioles, histologic changes were prominent in the specimens after 2 months, showing slight or little changes after that period. The thickening of the arteriole walls were mainly due to medial hypertrophy.
In muscular arteries changes were noted after 2 months and increased after that period, showing the most prominent changes in-4he 6 month specimens and medial hypertrophy was the most conspicuous findings.
This experimental results suggest the possibility that in chinical Waterston operation, pulmonary vascular changes may occur at the relatively earliest postoperative period, especially when the aorto￢pulmonary anastomosis stoma is a large one.
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