[Modified total cavopulmonary connection for treating patients with functional single ventricle].
OBJECTIVE
To modify the classic procedure for better surgical results of total cavopulmonary connection (TCPC).


METHODS
Modified TCPC was performed in 13 patients with functional single ventricle. In the modified TCPC procedure, the distal end of the superior vena cava (SVC) was connected with the upper edge of the right pulmonary artery (RPA) with the anastomosis orifice near the left side, and the proximal end with the lower edge of RPA with the anastomosis orifice near the right side. Among them, intra-atrial tunnel was established with a partial tube of PTFE using the lateral tunnel technique in 8 patients, and the distal end of the inferior vena cava (IVC) was directly connected with the lower edge of RPA using extracardiac conduit in the beating heart in 5.


RESULTS
One patient (7.7%) died early. Twelve patients survived and had the SatO(2) (94.6 +/- 1.2)% postoperatively while inspiring air. Angiography showed that most blood from IVC enters the right lung and most blood from SVC the left lung. No late mortality was seen during the follow up for 6 months to 2 years and 2 months. NYHA class I was noted in 10 patients and class II in 2. Echocardiography showed that left ventricular volume reduced significantly and ventricular function was normal.


CONCLUSIONS
Modified TCPC produces optimal blood flow between the two lungs, elevates postoperative Sat O(2) effectively, decreases ventricular volume load and improves ventricular functions.
Mei
J
J
Department of Thoracic and Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
Wang
Z
Z
Zhang
B
B
Hao
J
J
D000293:Adolescent; D006348:Cardiac Surgical Procedures; D002648:Child; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D016276:Ventricular Function