The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Jan 1984
Total cavopulmonary shunt operation in complex cardiac anomalies. A new operation.
Four patients with presently uncorrectable cyanotic cardiac anomalies underwent a new operation, "total cavopulmonary shunt operation" or "total right heart bypass operation." These anomalies included single ventricle, single atrium, common atrioventricular valve with or without regurgitation, pulmonary stenosis, and most important, absent inferior vena cava with azygos or hemiazygos continuation. All patients had had previous systemic-pulmonary shunts. The new operation consisted of end-to-side anastomosis between the superior vena cava with azygos or hemiazygos continuation and the confluent pulmonary artery, division or ligation of the pulmonary artery trunk, and replacement of the common atrioventricular valve when regurgitation was present. ⋯ The two long-term survivors are in significantly improved condition, both clinically and hemodynamically. We believe that this new operation is promising in the treatment of the otherwise uncorrectable complex cardiac anomalies associated with azygos or hemiazygos continuation of the inferior vena cava. A longer follow-up is certainly mandatory before final conclusions can be reached.