title: Total extracardiac right heart bypass using a polytetrafluoroethylene graft.
abstract: BACKGROUND
  With regard to hemodynamics and late arrhythmias, total cavopulmonary connection has been accepted as a superior technique as compared to Fontan type procedures. However, intra-atrial baffles for lateral tunnel or conduit remain construction retain some similar disadvantages.
  
  
  METHODS
  As an alternative to total cavopulmonary connection, total extracardiac right heart bypass using a polytetrafluoroethylene tube for the inferior vena cava to pulmonary artery connection may obviate some problems. Five patients with complex heart disease necessitating one ventricle repair underwent this procedure successfully.
  
  
  RESULTS
  Aortic cross-clamp time ranged from 0 to 24 minutes (mean = 15.8 min). No case required takedown or an additional step. Although the follow-up periods have been relatively short (mean = 19 months), all patients are well and no arrhythmic event or thromboembolic episode has occurred.
  
  
  CONCLUSIONS
  As a simple, safe, and reproducible procedure, total extracardiac right heart bypass is an alternative to Fontan or total cavopulmonary connection procedure.
authors.affiliation: Department of Cardiac Surgery, Kinki University Hospital, Osaka, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Iemura
authors.forename: H
authors.initials: H
authors.lastname: Oku
authors.forename: T
authors.initials: T
authors.lastname: Saga
authors.forename: H
authors.initials: H
authors.lastname: Kitayama
authors.forename: T
authors.initials: T
authors.lastname: Matumoto
mesh_terms: D001807:Blood Vessel Prosthesis; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D005260:Female; D006321:Heart / Q000503:physiopathology; D018610:Heart Bypass, Right; D006801:Humans; D008297:Male; D011138:Polytetrafluoroethylene; D011184:Postoperative Period; D016896:Treatment Outcome
chemical_list: D011138:Polytetrafluoroethylene