Total Cavopulmonary Connection for Functionally Single Ventricle without Cardiopulmonary Bypass Support.
A heart with two atriums but one ventricle, an anatomy with a unique physiology, is responsible for many creative surgical and interventional approaches in history. Different surgical techniques have been used to address this strange physiology of parallel circulation. All these attempts met with failure till the concept of Fontan circulation was described. Currently, controversy exists between multistage vs. single stage total cavopulmonary connections. Total cavopulmonary connection is the only definitive procedure performed to provide palliation for patients with complex congenital heart defects which cannot support a biventricular circulation. We report a case with tricuspid atresia with transposition of great arteries and pulmonary stenosis with persistant left-sided superior vena cava and functionally single ventricle. Patient successfully underwent single stage extra-cardiac total cavopulmonary connection. In this case, bilateral Glenn with extra-cardiac inferior vena cava to main pulmonary artery shunt was performed off-pump.
Department of Paediatric Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD), Karachi.
Sohail Khan
SK
Bangash
Department of Paediatric Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD), Karachi.
Iqbal Hussain
IH
Pathan
Department of Paediatric Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD), Karachi.
Saad Bader
SB
Zaki
D000293:Adolescent; D000714:Anastomosis, Surgical; D018729:Fontan Procedure / Q000379:methods*; D006325:Heart Atria / Q000601:surgery; D006330:Heart Defects, Congenital / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities / Q000601:surgery*; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000601:surgery*