Related Experiment Video
Updated: May 28, 2026
Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
Published on: October 11, 2024
Long-term results of total cavopulmonary connection with low ejection fraction
Shuichi Shiraishi1, Hideki Uemura, Koji Kagisaki
1Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Fujishiro-dai, Suita, Osaka, Japan. sshuichi@med.niigata-u.ac.jp
Purpose:
The aim of this study was to investigate the surgical outcomes and change in cardiac performance after total cavopulmonary connection (TCPC) in patients with reduced ventricular ejection preoperatively.
Methods:
Among the 195 patients undergoing TCPC between 1990 and 2001 were 52 who had a preoperative ejection fraction of ≤50% (30%-50%, mean 44%). A dominant ventricle was of the morphologically right type in 81% of patients.
Results:
A total of 9 of the 52 patients died early. Two patients died in the intermediate term. Postoperative exercise testing showed maximum oxygen uptake of 26.4 ± 5.8 ml/kg/min (anaerobic threshold 18.3 ± 3.2 ml/kg/ min). The cardiac index was 3.1 ± 0.9 l/min/m(2) at 1 year after TCPC, with no fundamental change at 5 years (3.1 ± 0.8 l/min/m(2)). The end-diastolic volume of the dominant ventricle was 130% ± 74% of the anticipated normal value at 1 year and 93% ± 27% at 5 years after TCPC, with ejection fractions of 48% ± 13% and 49% ± 9%, respectively. When these parameters were plotted for the individual patients, the ejection fraction increased during the first postoperative year, with the percent end-diastolic volume decreasing in 31 survivors; the trend appeared atypical in the remaining 12 survivors. Even in these patients, however, the parameters eventually changed toward favorable circumstances 5 years after TCPC.
Conclusion:
Change in ventricular function was not necessarily pessimistic after TCPC in patients with reduced ventricular contraction preoperatively.
