[Total cavopulmonary connection. Prevention of inferior vena cava obstruction by postero-external enlargement of the right atrium].
Rerouting the venal caval blood flow towards the pulmonary artery is a functional surgical procedure suitable for several complex congenital heart diseases. Practically, after division of the terminal end of the superior vena cave (SVC) close to the right atrium, the two segments of the SVC are connected to the right pulmonary artery by termino-lateral anastomosis. The inferior vena caval (IVC) blood flow is conducted to the SVC ostium through an intracardiac atunnel constructed within the right atrium. The SVC ostium, smaller than the IVC ostium, may create a haemodynamic obstruction. Eight patients with complex congenital heart diseases were successfully operated upon according to this total cavopulmonary connection procedure which was always associated with widening of the postero-external area of the SVC and right atrium. Post-operative periods were uneventful. Transient supraventricular arrhythmia occurred in one case.
Planche
C
C
Hôpital Marie-Lannelongue, Le Plessis-Robinson.
Serraf
A
A
Lacour-Gayet
F
F
D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006325:Heart Atria / Q000601:surgery*; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D007223:Infant; D011651:Pulmonary Artery / Q000601:surgery*; D014684:Venae Cavae / Q000601:surgery*
Connexion cavo-pulmonaire totale. Prévention d'un obstacle cave inférieur par agrandissement postéro-externe de l'oreillette droite.