Transposition of the Great Arteries 25 years after Rashkind Balloon Septostomy

The international symposium on transposition of the great arteries was held in Munich on May 3-5, 1991. It was organized by the German Heart Center Muni eh with two aims: firstly, to commemorate the 25th anniversary of Dr. Rashkind's publication: "Creation of an atrial septal defect without thoracotomy" (which appeared in 1966 in the Journal of the American Medical Association), and to honor this great pediatric cardiologist, who was one the pioneers of interventional catheterization. secondly, to give an overview of current medical knowledge about the pre- and postnatal diagnosis, medical and surgical treatment, and postoperative evalua tion of transposition of the great arteries. Fig. 1. Dr. Rashkind in his Iabaratory checking his balloon catheter V This symposium brought tagether embryologists, morphologists, experts in fetal cardiology, pediatric cardiologists, and pediatric cardiac surgeons from 10 different countries. Thus, we were able to describe the current state-of-the-art of pre- and postnatal management and the surgical treatment of this second most common con genital cyanotic anomaly of the heart. Dr. Rashkind's approach to create an atrial septal defect in the setting of com plete transposition of the great arteries dramatically changed the natural history of this cyanotic heart defect, which carried a 90% neonatal mortality before this effec tive palliation became available.

Inhalt
Bill Rashkind's contribution to pediatric cardiology.- The impact of Dr. Rashkind on the development of interventional cardiology.- Prenatal pathogenesis of the transposition of great arteries.- Development of coronary arteries in transposition of the great arteries.- Transposition of the great arteries: advantages and results of prospective fetal detection. Experience from 19831990.- The perinatal circulation and aortopulmonary transposition.- Balloon atrial septostomy: The Rashkind procedure (19541990) historical and technical aspects.- Role of prostaglandin infusion prior to surgery in complete transposition of the great arteries.- The natural history of transposition after balloon septostomy and before surgical repair.- The natural history of the patient with transposition of the great arteries before atrial septostomy.- The pulmonary circulation in transposition of the great arteries.- Cineangiographic diagnosis of coronary artery anatomy in transposition of the great arteries and double outlet right ventricle: Significance of aortic intramural coronary arteries.- Mustard operation for transposition: Historical aspects and results.- Long-term results after atrial repair for transposition of the great arteries.- The rapid two-stage arterial switch operation.- Anatomic repair for complex transposition.- Re-operations after surgery for transposition of the great arteries.- Systolic and diastolic function after atrial repair of simple transposition of the great arteries.- P31MR Spectroscopy of right-ventricular myocardium after atrial repair for transposition of the great arteries.- Supra pulmonary stenosis after arterial switch operation for transposition of the great arteries.- The role of myocardial perfusion scintigraphy and echocardiographicwall-motion analysis in the postoperative assessment of patients after the arterial-switch operation.

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