Related Experiment Video

Updated: Aug 19, 2026

Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart
08:49

Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart

Published on: May 11, 2018

Arrhythmias after the Fontan procedure. Comparison of total cavopulmonary connection and atriopulmonary connection

S Balaji1, M Gewillig, C Bull

  • 1Cardiothoracic Unit, Hospital for Sick Children, London, UK.

Circulation
|November 1, 1991
PubMed

Insights

Total cavopulmonary connection (TCPC) shows lower early arrhythmia and mortality rates compared to atriopulmonary connection (APC) in pediatric heart surgery patients. This suggests TCPC may be a safer surgical option for complex congenital heart defects.

Area of Science:

  • Cardiology
  • Pediatric Cardiac Surgery
  • Electrophysiology

Background:

  • Atriopulmonary connection (APC) and total cavopulmonary connection (TCPC) are surgical procedures for complex congenital heart defects.
  • Arrhythmia is a potential complication following these cardiac surgeries.

Purpose of the Study:

  • To compare the incidence of arrhythmia and associated mortality between APC and TCPC.
  • To evaluate the long-term outcomes of arrhythmia in patients who underwent either APC or TCPC.

Main Methods:

  • A retrospective comparison of 40 patients undergoing APC and 40 patients undergoing TCPC between 1986 and 1990.
  • Analysis of pre-operative, early post-operative, and long-term follow-up (ambulatory ECG) arrhythmia data.
  • Comparison of hospital mortality and arrhythmia-related mortality between the two groups.

Main Results:

  • Hospital mortality was significantly higher after APC (15/40) compared to TCPC (6/40).
  • Early post-operative atrial flutter (AFL) was more frequent and associated with higher mortality after APC (9 cases, 8 deaths) versus TCPC (2 cases, 0 deaths).
  • Long-term arrhythmia incidence and mortality were comparable between the groups, though early outcomes favored TCPC.

Conclusions:

  • Total cavopulmonary connection (TCPC) is associated with lower early postoperative arrhythmia and mortality compared to atriopulmonary connection (APC).
  • TCPC appears to be a safer initial surgical approach, particularly in patients with complex cardiac defects.
  • Further investigation into long-term electrophysiological outcomes may be warranted for both procedures.

More Related Videos

Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation07:28

Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation

Published on: October 11, 2024

Wireless Telemetry Device Implantation in a Fontan Ovine Model for Continuous and Long-Term Hemodynamic Monitoring06:29

Wireless Telemetry Device Implantation in a Fontan Ovine Model for Continuous and Long-Term Hemodynamic Monitoring

Published on: May 2, 2025

Related Concept Videos

Chambers of the Heart01:16

Chambers of the Heart

The human heart is a complex organ made up of four chambers: the right and left atria and the right and left ventricles. These internal chambers are separated by partitions known as the interatrial and interventricular septa. The exterior of the heart features a groove known as the coronary sulcus that demarcates the atria from the ventricles, while the anterior and posterior interventricular sulci distinguish between the two ventricles.
Deoxygenated blood from the body is received in the right...
Cardiac Catheterization II: Right Heart Catheterization01:21

Cardiac Catheterization II: Right Heart Catheterization

Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...