CAVOPULMONARY ANASTOMOSIS IN STAGING TOWARD FONTAN OPERATION - PATHOLOGICAL SUBSTRATES

Background. A review of the history and practice of cavopulmonary conn ections in staging toward Fontan operation and the pathologic experien ce at Padua University is presented. Methods. Gross and histologic ass essment of the heart-lung blocks removed at autopsy in the cases in wh ich the cause of death could be related to a dysfunction of the cavopu lmonary anastomosis were performed. Results. The main complications we re distortion of the intraatrial tunnel and thrombosis of the pulmonar y branches of the cavopulmonary anastomosis. Conclusions. The cavopulm onary anastomosis remains a widespread procedure, both as a preliminar y step to a Fontan operation and as an integral part of a Fontan or mo dified Fontan procedure in all those cardiac malformations characteriz ed by a hypoplastic right or left ventricle in which these ventricles are too small to support the whole circulation. (C) 1998 by The Societ y of Thoracic Surgeons.