Total cavopulmonary connection for complex cardiac anomalies with the functional single ventricle

Summary

From Aug. 1999 to Feb. 2001, 8 patients with complex congenital heart diseases, including 5 cases accompanied by hypoplastic left ventricle and 3 by hypoplastic right ventricle, were subjected to total cavopulmonary connection (TCPC). Eight cases underwent the operation under cardiopulmonary bypass and 7 of whom under no cardiac clamp. Seven cases received cavopulmoanry anastomosis by flaring method and one case by end-side anastomosis. All the patients underwent the intracardiac tunnels to drain inferior vena cava and plus 4 mm fenestration except one. The results showed that 6 patients had postoperative oxygen saturation more than 90 %, sinus rhythm, no anastomostic stoma obstruction, no flow reguigitation and CVP< 16 cmH₂O. Two (25 %) patients died postoperatively from high venous pressure of 18–20 cmH₂O, finally from cardiac failure and anoxima. It was concluded that TCPC was an effective treatment for complex congenital cardiac diseases, especially with ventricular maldevelopment. Intracardiac tunnel plus 4 mm fenestration and flaring cavopulmonary anastomosis could prevent the postoperative complications. Larger anastomotic stoma, venous pressure less than 16 cmH₂O and artery saturation more than 90 % might indicate excellent TCPC procedures in our experience.