[Total cavopulmonary shunt operation for single atrium and single ventricle]

A 17-year-old woman with single atrium, single ventricle, common atrioventricular valve and hemiazygous continuation underwent a total cavopulmonary shunt operation successfully. She had been cyanotic and with a heart murmur since two months of age. She was first seen at our hospital at three years of age. Catheterization, performed at the same time, had revealed pulmonary stenosis and transposition of the great arteries. At 17 years of age, catheterization was again performed, and a clinical diagnosis of single atrium, single ventricle, common atrioventricular valve and hemiazygous continuation was made. After the diagnosis was confirmed, a total cavopulmonary after ligation of the main pulmonary artery and shunt operation was performed division of the left superior vena cava, the distal end of the left superior vena cava was anastomosed to the confluent pulmonary artery. Two hours after return to ICU, extubation was done. The cardiac index was 4.36 L/min/m2 with central venous pressure of 145 mmH2O. The arterial oxygen saturation was 88.4%. After the surgery, this woman is doing well, with decreased CTR and improved exercise tolerance. Total cavopulmonary shunt can produce a marked improvement in the condition of patients with some type of complex cyanotic congenital heart disease.