title: Institutional Experience of Assisting Cavopulmonary Circulation With Central Systemic Artery-to-Central Systemic Vein Shunt.
abstract: OBJECTIVE
  Patients who have undergone a previous bidirectional superior cavopulmonary anastomosis and have hypoxemia and anatomy considered unsuitable for the Fontan completion present a difficult subset. We performed common carotid artery-to-internal jugular vein (CCA-IJV) shunt in these patients.
  
  
  METHODS
  Between January 2010 and January 2015, eight patients underwent a CCA-IJV shunt. Their records were analyzed retrospectively.
  
  
  RESULTS
  There were no early deaths. The baseline arterial saturation prior to the shunt procedure was median 67% (range 60%-72%), which increased to median 83% (range 80%-90%) after the procedure. The preoperative arterial oxygen partial pressure (Pao 2) ranged from 30 to 49 mm Hg (median 40 mm Hg). The hematocrit dropped from a preoperative median of 65% (range 55%-72%) to a median of 45% (range 42%-48%) after the procedure. Median intensive care unit stay was 2.5 days, and the median hospital stay was 7 days. Median follow-up was 24 months. At the last follow-up, these patients were classified in New York Heart Association class II.
  
  
  CONCLUSIONS
  In a selected group of patients who are considered to be unsuitable for completion of Fontan circulation following superior cavopulmonary anastomosis, creation of a CCA-IJV shunt may be helpful to improve saturations and improve ventricular function.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
authors.forename: Palleti
authors.initials: P
authors.lastname: Rajashekar
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India sachintalwar@hotmail.com.
authors.forename: Sachin
authors.initials: S
authors.lastname: Talwar
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
authors.forename: Shyam Sunder
authors.initials: SS
authors.lastname: Kothari
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Anand
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
authors.forename: Balram
authors.initials: B
authors.lastname: Airan
mesh_terms: D000328:Adult; D001243:Assisted Circulation / Q000379:methods*; D005260:Female; D018610:Heart Bypass, Right / Q000379:methods*; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D011652:Pulmonary Circulation / Q000502:physiology*; D012189:Retrospective Studies
keywords: CHD; cavopulmonary anastomosis; congenital heart surgery; functionally univentricular heart; univentricular heart