Appropriate route selection for extracardiac total cavopulmonary connection in apicocaval juxtaposition

The Annals of Thoracic Surgery
Sei MorizumiYuji Hiramatsu

Abstract

A malpositioned heart with apicocaval juxtaposition may complicate the management of patients with functional single ventricles when total cavopulmonary connection is performed. We reviewed our experience with extracardiac total cavopulmonary connection in patients with apicocaval juxtaposition with a special focus on route selection and outcomes. Of 68 patients who underwent extracardiac total cavopulmonary connection at our hospitals, 10 patients with apicocaval juxtaposition were included in this study. The mean follow-up was 40 ± 28 months. Patient demographics were compared with data on patients without apicocaval juxtaposition. The age at operation was 8 ± 7 years. We carefully chose conduit routes to create satisfactory fluid dynamics. The conduit was placed between the inferior vena cava and the ipsilateral pulmonary artery in 2 patients, and the conduit crossed midline in 8 patients. The mean postoperative pulmonary artery pressure was 13 ± 2 mm Hg. The surgical and postoperative data were not significantly different when compared with the patients without apicocaval juxtaposition. There were no conduit-related early or late complications except for 1 patient who had poor ventricular function. Extracardiac total cavopu...Continue Reading

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Citations

Mar 27, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Masahiro YoshidaVictor O Morell
Dec 3, 2014·The Annals of Thoracic Surgery·Zhong Qun ZhuJing Fen Liu
Sep 25, 2014·Asian Cardiovascular & Thoracic Annals·Juan-Miguel Gil-JaurenaMayte González-López
May 8, 2020·Pediatric Cardiology·Zhenglun Alan WeiMahesh Kappanayil
Sep 27, 2020·The Annals of Thoracic Surgery·Kenta ImaiHajime Ichikawa

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