Total cavopulmonary connection for complex cardiac anomalies with the functional single ventricle

J Tongji Med Univ. 2001;21(2):149-51. doi: 10.1007/BF02888082.

Abstract

From Aug. 1999 to Feb. 2001, 8 patients with complex congenital heart diseases, including 5 cases accompanied by hypoplastic left ventricle and 3 by hypoplastic right ventricle, were subjected to total cavopulmonary connection (TCPC). Eight cases underwent the operation under cardiopulmonary bypass and 7 of whom under no cardiac clamp. Seven cases received cavopulmonary anastomosis by flaring method and one case by end-side anastomosis. All the patients underwent the intracardiac tunnels to drain inferior vena cava and plus 4 mm fenestration except one. The results showed that 6 patients had postoperative oxygen saturation more than 90%, sinus rhythm, no anastomostic stoma obstruction, no flow regurgitation and CVP < 16 cmH2O. Two (25%) patients died postoperatively from high venous pressure of 18-20 cmH2O, finally from cardiac failure and anoxima. It was concluded that TCPC was an effective treatment for complex congenital cardiac diseases, especially with ventricular maldevelopment. Intracardiac tunnel plus 4 mm fenestration and flaring cavopulmonary anastomosis could prevent the postoperative complications. Larger anastomotic stoma, venous pressure less than 16 cmH2O and artery saturation more than 90% might indicate excellent TCPC procedures in our experience.

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • Heart Bypass, Right / methods*
  • Heart Defects, Congenital / physiopathology
  • Heart Defects, Congenital / surgery*
  • Heart Ventricles / physiopathology
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Pulmonary Artery / surgery