Total cavopulmonary connection (TCPC) for complicated congenital heart malformations.
We reviewed our experience with 40 patients who had undergone total cavopulmonary connection (TCPC) during the past three years. Thirty-one patients had functional single ventricle; only 8 of these with tricuspid atresia, five patients had complex forms of double outlet right ventricle (DORV), and four complex A-V canal. Previous palliative procedures, mostly systemic-pulmonic shunts, were performed in 34 patients. Concomitant procedures were required in 18 patients, mainly reconstruction of distorted pulmonary arteries. A subgroup of 14 high risk patients, that did not fulfil the classical Fontan criteria, underwent 4 mm fenestration of the intra-atrial baffle. There were three (7.5%) early postoperative deaths which occurred in the higher risk group (fenestrated group). However, the remaining patients were all in functional class I or II. Total cavopulmonary connection provides reasonably good definitive palliation for patients with single ventricle physiology. Fenestration of the intra-atrial baffle increases the number of candidates suitable for the Fontan procedure, although the exact inclusion criteria for these patients has yet to be defined.
Snir
E
E
Departments of Cardiothoracic and Pediatric Cardiology, Beilinson Medical Center, Petach Tikva, Israel.
Raanani
E
E
Birk
E
E
Zeevi
B
B
Berant
M
M
Vidne
B A
BA
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004310:Double Outlet Right Ventricle / Q000601:surgery; D004694:Endocardial Cushion Defects / Q000601:surgery; D005500:Follow-Up Studies; D018729:Fontan Procedure; D018610:Heart Bypass, Right; D006330:Heart Defects, Congenital / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities; D006801:Humans; D010166:Palliative Care; D011183:Postoperative Complications; D011651:Pulmonary Artery / Q000601:surgery; D013997:Time Factors