title: [Bidirectional cavopulmonary diversion for tricuspid atresia. Experience in the National Institute of Cardiology].
abstract: Bidirectional cavopulmonary shunt is an alternative palliative procedure for patients with congenital cyanotic heart disease, specially those patients less than "ideal" candidates for a Fontan's procedure. We present our results with this shunt in patients with tricuspid atresia. Twenty patients with tricuspid atresia were operated on with this shunt, with these associated defects: 20 atrial septal defect, 17 ventricular septal defect, 10 pulmonary stenosis, 1 pulmonary atresia and 1 transposition of the great arteries. Sex: 10 males and 10 females; the age was 27 days to 6 years (mean 1.8 years), the weight was 3.2 kg to 24 kg (mean 10.7 kg), the mean pulmonary artery pressure was 11 to 24 mmHg (mean 17 mmHg), pulmonary vascular resistance was 1.5 to 5 UW (mean 3.1 UW). Postoperative oxygen saturation improved 15 to 120%. All patients survived the surgical procedure. Three patients died in the immediate postoperative period, 2 due to a complications in the postoperative period and 1 due to sepsis. There were two late deaths, 1 sudden death after 6 months of the shunt, and 1 due to sepsis after a Fontan's procedure. Four patients presented pleural effusion and 2 pericardial effusion, they resolved well. We have 15 patients alive and well, in functional class I, and minimal cyanosis. We can conclude that this surgical procedure is useful in the management of patients with tricuspid atresia.
authors.affiliation: Departamento de Cirugía Cardiovascular de Tórax, Instituto Nacional de Cardiología Ignacio Chávez, INCICH, México, D.F.
authors.forename: E S
authors.initials: ES
authors.lastname: Ramírez Marroquín
authors.forename: J A
authors.initials: JA
authors.lastname: Santibáñez Salgado
authors.forename: J
authors.initials: J
authors.lastname: Calderón Colmenero
authors.forename: J
authors.initials: J
authors.lastname: Molina Méndez
authors.forename: V
authors.initials: V
authors.lastname: Herrera Alarcón
authors.forename: F
authors.initials: F
authors.lastname: Santibáñez Escobar
authors.forename: R
authors.initials: R
authors.lastname: Barragán García
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D018610:Heart Bypass, Right / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012307:Risk Factors; D018785:Tricuspid Atresia / Q000601:surgery*
vernacular_title: Derivación cavopulmonar bidireccional para la atresia tricuspídea. Experiencia en el Instituto Nacional de Cardiología.