E. Snir et al., TOTAL CAVOPULMONARY CONNECTION FOR COMPLICATED CONGENITAL HEART MALFORMATIONS, Israel journal of medical sciences, 30(8), 1994, pp. 642-645
We reviewed our experience with 40 patients who had undergone total ca
vopulmonary connection during the past 3 years. Thirty-one patients ha
d functional single ventricle, only 8 with tricuspid atresia; five had
complex forms of double outlet right ventricle, and 4 complex A-V can
al. Previous palliative procedures, mostly systemic-pulmonic shunts, w
ere performed in 34 patients. Concomitant procedures, mainly reconstru
ction of distorted pulmonary arteries, were required in 18 patients. A
subgroup of 14 high risk patients, who did not fulfil the classical F
ontan criteria, underwent 4 mm fenestration of the intraatrial baffle.
There were 3 (7.5%) early post-operative deaths that occurred in the
higher risk group (fenestrated group). However, the remaining patients
were all in functional class I or II. Total cavopulmonary connection
provides reasonably good definitive palliation for patients with singl
e ventricle physiology. Fenestration of the intraatrial baffle increas
es the number of candidates suitable for the Fontan procedure, althoug
h the exact inclusion criteria for these patients has yet to be define
d.