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Total cavopulmonary connection with extraatrial tunnel

Ren Fu Zhang1, Han Dong Gong, Hong Yu Zhu

  • 1Department of Cardiovascular Surgery, Shenyang Northern Hospital, Shenyang, Liaoning, People's Republic of China.

Asian Cardiovascular & Thoracic Annals
|June 25, 2002
PubMed

Insights

Total cavopulmonary connection with an extraatrial tunnel effectively treated complex congenital heart disease in 9 patients, showing no mortality and good functional outcomes. Key factors for success include surgical technique and avoiding complications.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Complex congenital heart disease presents significant surgical challenges.
  • Previous palliative procedures may require further intervention.
  • The total cavopulmonary connection (TCPC) is a surgical option for single-ventricle physiology.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of TCPC with an extraatrial tunnel in complex congenital heart disease.
  • To identify critical factors for successful surgical outcomes.

Main Methods:

  • Retrospective analysis of 9 patients undergoing TCPC with an extraatrial tunnel between April 1997 and February 2000.
  • Patient diagnoses included single ventricle, double-outlet right ventricle, mitral atresia, and tricuspid atresia.
  • Follow-up ranged from 11 months to 3 years.

Main Results:

  • No operative mortality was observed.
  • One patient required reoperation for bacterial endocarditis and tunnel replacement.
  • At follow-up, 3 patients were in New York Heart Association functional class I, and 6 were in class II.
  • Refractory supraventricular tachycardia in one patient was successfully treated by the TCPC procedure.

Conclusions:

  • TCPC with an extraatrial tunnel is a safe and effective treatment for selected complex congenital heart disease.
  • Favorable outcomes are associated with appropriate surgical indications, avoidance of aortic cross-clamping and cardiac arrest, and unobstructed vascular anastomoses.
  • This technique can resolve complex arrhythmias in patients with single-ventricle physiology.

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