[Total cavopulmonary connection in complex heart defects with a single functional ventricle].

Abstract

Nineteen children aged between 1.5 and 9.8 years (10 patients younger than 4 years) underwent total cavopulmonary connection (TCPC) for complex congenital heart defects other than tricuspid atresia. Diagnoses included double inlet left ventricle (n = 11), transposition of the great arteries with a large ventricular septal defect (n = 4), double outlet right ventricle (n = 2), congenitally corrected transposition of the great arteries with a large ventricular septal defect (n = 1) and criss-cross heart (n = 1). Two patients had situs ambiguous with polysplenia syndrome and four patients had anomalous systemic venous return. Thirty-six palliative procedures were performed in 15 patients before TCPC. The patients were selected according to the selection criteria of Choussat and Fontan. Four patients (21%) died between the 1st and 12th postoperative day because of low cardiac output syndrome (n = 2), supraventricular tachycardia unresponsive to treatment (n = 1), and cerebral edema (n = 1). In one patient take down of TCPC was performed for persistent low cardiac output syndrome. Four of these five patients were younger than 4 years old and had one or more additional risk factors. Postoperative complications were persistent pleural or pericardial effusions (n = 4), transient supraventricular tachycardia (n = 2), and low cardiac output syndrome (n = 1). There was no late death. Follow-up was available in 12 patients. At a mean follow-up of 15 +/- 9 months, nine patients are in NYHA-functional class I, two patients in class II, and one patient in class III. Postoperative cardiac catheterization revealed satisfactory results in seven of eight patients.(ABSTRACT TRUNCATED AT 250 WORDS)

• Authors: A Gamillscheg, B Rigler, A Beitzke, G Zobel, J I Stein, D Dacar
• Journal: Zeitschrift fur Kardiologie (Z Kardiol) Vol. 83 Issue 7 Pg. 513-8 (Jul 1994) ISSN: 0300-5860 [Print] Germany
• Vernacular Title: Totale kavopulmonale Konnektion bei komplexen Herzfehlern mit funktionell singulärem Ventrikel.
• PMID: 7941652 (Publication Type: English Abstract, Journal Article)

Chemical References

• Polytetrafluoroethylene

Topics

• Anastomosis, Surgical
• Blood Vessel Prosthesis
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Heart Defects, Congenital (mortality, physiopathology, surgery)
• Heart Ventricles (abnormalities, surgery)
• Hemodynamics (physiology)
• Humans
• Infant
• Male
• Polytetrafluoroethylene
• Postoperative Complications (mortality, physiopathology)
• Pulmonary Artery (surgery)
• Survival Rate
• Tricuspid Atresia (mortality, physiopathology, surgery)
• Vena Cava, Superior (surgery)