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J Thorac Cardiovasc Surg 2006;132:162-163
© 2006 The American Association for Thoracic Surgery

Brief Communication

Newly designed extracardiac direct total cavopulmonary connection with merged connection and mixing route

Nobuyuki Ishibashi, MD a , * , Mitsuru Aoki, MD a , Manabu Watanabe, MD a , Hiromichi Nakajima, MD b , Hiroyuki Aotsuka, MD b , Tadashi Fujiwara, MD a

a Department of Cardiovascular Surgery, Chiba Children's Hospital, Chiba, Japan
b Department of Cardiology, Chiba Children's Hospital, Chiba, Japan

Received for publication February 11, 2006; accepted for publication February 20, 2006.

* Address for reprints: Nobuyuki Ishibashi, MD, Departments of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. (Email: nobishibashi-ths@umin.ac.jp).

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

In total cavopulmonary connection (TCPC) streamlined cavopulmonary anatomic designs with minimum energy losses and an even flow to bilateral lungs are important to obtain optimal clinical results. However, in the conventional anatomic design of TCPC, it is difficult to obtain a good energy efficiency with balanced inferior vena caval (IVC) flow distribution. In 2003, using a computational fluid dynamics model, the lateral tunnel Fontan operation after the hemi-Fontan procedure was demonstrated to have the advantages of a good energy efficiency and a balanced distribution of the IVC flow based on the presence of a divergent shape in both the superior vena cava (SVC) and IVC anastomoses, the anteroposterior offset of the 2 caval anastomoses, and complete mixing in the right atrium. 1 Go We agreed with this explanation but considered that there was a risk of development of right atrial dilation and late arrhythmia.

Based on the above results, we newly designed and performed TCPC with the merged connection of the superior and inferior venous flow through direct anastomosis . . . [Full Text of this Article]






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