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Modified Total Cavopulmonary Connection: An Alternative Approach in the Presence of Left Superior Vena Cava
Author(s) -
COOLEY DENTON A.,
SHARMA BALJIT K.,
LAMMERMEIER DAVID E.,
REUL GEORGE J.
Publication year - 1990
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.1990.tb00757.x
Subject(s) - medicine , coronary sinus , cardiology , pulmonary artery , superior vena cava , anastomosis , inferior vena cava , persistent left superior vena cava , venous return curve , left pulmonary artery , surgery , hemodynamics
A bstract A technical modification to the total cavopulmonary connection in the presence of left superior vena cava (LSVC) is described. Systemic venous to pulmonary artery continuity is achieved by direct anastomosis of the right superior vena cava (RSVC) to the right pulmonary artery. Blood from the inferior vena cava (IVC) is diverted by an intraatrial baffle to the coronary sinus. The LSVC is then anastomosed to either the left pulmonary artery or the main pulmonary artery in an end‐to‐side or side‐to‐side manner. By using this technique, we maintain the basic principle of excluding the right atrial chamber from the systemic venous circuit, thereby reducing the potential obstructive complications that have been noted with other forms of complex intraatrial baffles. We have used this technique successfully in three patients with various forms of complex congenital cardiac defects.