Takahiro Hisaoka, Takeshi Hiramatsu, Yoshitaka Okamura
Wakayama Medical University.
Japan
General Thoracic and Cardiovascular Surgery
Gen Thorac Cardiovasc Surg 2009; 57: 307-309
DOI: 10.1007/s11748-008-0348-2
Abstract
If the heart is malpositioned with apicocaval juxtaposition (ACJ), what constitutes the ideal course for the conduit pathway of a total cavopulmonary connection must be considered. When the conduit is positioned between the inferior vena cava and the same side of the pulmonary artery behind the ventricle, potential stenosis of the conduit due to compression by the ventricle or obstruction of the pulmonary vein due to compression by the conduit must be recognized. We reported two cases of ACJ in which a straight conduit pathway behind the ventricle was accomplished. Comprehensive dissection of the heart, especially the posterior side of the ventricle, to make a wide opening into the thoracic cavity is needed to obtain enough space behind the ventricle. Postoperative catheter studies performed 6 months after the operations showed no obstruction or deformity of the conduit or the pulmonary veins, and the mean pulmonary artery pressure measured 9 mmHg in both patients.
Category
Stenosis or Obstruction of Pulmonary Veins: Other Categories. Surgical Method to Prevent Stenosis Associated with a Fontan Conduit
Year of Publication: 2009
Age Focus: Pediatric
Article Type: Case Reports or Retrospective Observations in Small Groups of Patients (≤10 patients)
Article Access: Free PDF File or Full Text Article Available Through PubMed or DOI: No