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J Thorac Cardiovasc Surg 2005;129:210-212
© 2005 The American Association for Thoracic Surgery

Brief Communications

A simple surgical technique for interventional transcatheter completion of the total cavopulmonary connection

^a Division of Cardiovascular Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
^b Division of Cardiology, Hospital for Sick Children, Toronto, Ontario, Canada

Received for publication April 8, 2004; revisions received April 14, 2004; accepted for publication April 20, 2004.

^* Address for reprints: Igor E. Konstantinov, MD, Division of Cardiovascular Surgery, Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G 1X8 Canada (E-mail: igorkonst@hotmail.com).

The first 20% of the full text of this article appears below.

Since the initial description of interventional completion of total cavopulmonary connection (TCPC),¹ few surgical maneuvers to prepare the heart for subsequent transcatheter univentricular repair have been reported.^2,3 Herein, we describe a simple technique that permits surgical preparation on the beating heart.

	Technique

 
The present technique evolved during experimentation in a porcine model. After approval by the Institutional Animal Care and Use Committee of the Research Institute in the Hospital for Sick Children, 4 Yorkshire pigs weighing 15, 20, 25, and 30 kg underwent a 2-staged procedure as described below. Superior vena cava (SVC) and inferior vena cava (IVC) were encircled with silk tapes in the first 3 animals to provide support for the covered stent (NuMed Inc, Hopkinton, NY). These support tapes were replaced with external stents (CP stent 8219, NuMed Inc) in the last animal.

Stage 1: Surgical preparation
Standard premedication, anesthesia induction, endotracheal intubation, muscle relaxation, and ventilation were achieved. Anesthesia was maintained with 1.5% to 2% isoflurane. The heart was exposed through a midline sternotomy. Heparin (300 IU/kg) was administered intravenously, and bicaval cannulation for cardiopulmonary bypass (CPB) was achieved. After institution of CPB, the caval veins were occluded by . . . [Full Text of this Article]

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