When the bi-directional Glenn is an unfavourable option: primary extracardiac inferior cavopulmonary connection as an alternative palliation.
The superior cavopulmonary anastomosis - bi-directional Glenn - is the standard palliation for single ventricle physiology. When upper body systemic venous anatomic concerns such as superior caval vein stenosis, hypoplasia, or inadequate collateral tributaries are present, a Glenn may be precluded or have a high risk of poor outcome. A primary inferior cavopulmonary connection with an extracardiac conduit is an alternative palliation that provides a generous pathway for pulmonary blood flow, with the additional benefit of including hepatic venous return. We report a case of primary extracardiac inferior cavopulmonary connection in a patient unsuitable for Glenn, with successful post-operative outcome and early follow-up.
1Division of Pediatric and Congenital Heart Surgery,University of Mississippi Medical Center,Jackson,Mississippi,USA.
Ali
A
Dodge-Khatami
2Division of Pediatric and Fetal Cardiology,University of Mississippi Medical Center,Jackson,Mississippi,USA.
Avichal
A
Aggarwal
2Division of Pediatric and Fetal Cardiology,University of Mississippi Medical Center,Jackson,Mississippi,USA.
Mary B
MB
Taylor
4Division of Pediatric Anesthesiology,The Children's Heart Center,University of Mississippi Medical Center,Jackson,Mississippi,United States of America.
Douglas
D
Maposa
1Division of Pediatric and Congenital Heart Surgery,University of Mississippi Medical Center,Jackson,Mississippi,USA.
Jorge D
JD
Salazar
D000072226:Computed Tomography Angiography; D018729:Fontan Procedure; D018610:Heart Bypass, Right / Q000379:methods*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D008297:Male; D011184:Postoperative Period; D011651:Pulmonary Artery / Q000601:surgery*; D014683:Vena Cava, Superior / Q000601:surgery*
CHD; Fontan; Glenn