title: Staged Fontan's operation for unguarded tricuspid orifice with pulmonary atresia.
abstract: We report a rare case of unguarded tricuspid orifice with pulmonary atresia, which is devoid of any guarding valvular tissue at tricuspid annulus. A left Blalock-Taussig shunt was constructed on the 17th day of life. At 4 years of age, a bidirectional Glenn's operation was performed for the further growth of the pulmonary bed and the volume reduction of the left ventricle. Finally, an extracardiac cavo-pulmonary connection was created using a ringed Gore-Tex graft at 6 years of age. Staged Fontan's strategy may contribute to a good surgical outcome for this highly lethal anomaly.
authors.affiliation: Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. mhirota@md.okayama-u.ac.jp
authors.forename: Masanori
authors.initials: M
authors.lastname: Hirota
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kawada
authors.forename: Kozo
authors.initials: K
authors.lastname: Ishino
authors.forename: Shunji
authors.initials: S
authors.lastname: Sano