From June 1998 to March 2008, 22 patients underwent staged TCPC for complex
congenital heart diseases. Among them, 9 were univentricular and pulmonary artery valve
stenosis; 3 were univentricular and pulmonary artery atresia; 1 was
transposition of great arteries,
crisscross heart and pulmonary artery valve
stenosis; 1 was
complete atrioventricular canal defects, left ventricular hypoplasia, pulmonary artery atresia and atrioventricular valvular regurgitation; 1 was
complete atrioventricular canal defects, left ventricular hypoplasia, pulmonary artery valve
stenosis and atrioventricular valvular regurgitation after Glenn procedure; 1 was mirror image
dextrocardia, single ventricle, pulmonary artery atresia, major aortopulmonary collateral arteries (MAPCAs) and right pulmonary
arteriovenous fistula after Glenn procedure; 4 were
tricuspid atresia and pulmonary artery valve
stenosis; 1 was
tricuspid atresia and
pulmonary atresia; 1 was mirror image
dextrocardia, double-outlet of right ventricle, left ventricular hypoplasia, pulmonary artery
valve stenosis, tricuspid incompetence, and MAPCAs. Among them, 5 patients received systemic-to-pulmonary artery shunt,
bidirectional Glenn procedure and TCPC. Seventeen patients received
bidirectional Glenn procedure, the mean age was (5.9+/-4.4) years old. Pulmonary artery pressure pre-Glenn procedure was 17 to 20 mm Hg (1 mm Hg=0.133 kPa). Atrioventricular valve incompetence in 3 patients. Nakata index was less than 200 mm2/m2 in 4 patients before the first stage operation. The age of TCPC procedure was (9.6+/-4.9) years old, the interval time was (3.7+/-1.2) years.
RESULTS: There was one in-hospital death, the mortality was 4.5%. The patient with univentricular and
pulmonary atresia, received systemic-to-pulmonary artery shunt,
bidirectional Glenn procedure and TCPC and died of pneumorrhagia. Other patients were recovered well, postoperative central venous pressure was 12 to 18 mm Hg, percutaneous oxygen saturation was 90% to 96%. The cardiac function were in NYHA class I to II.
CONCLUSIONS: