Total Cavopulmonary Connection for Complex Cardiac Anomalies with the Functional Single Ventricle

From Aug. 1999 to Feb. 2001, 8 patients with complex congenital heart diseases, including 5 cases accompanied by hypoplastic left ventricle and 3 by hypoplastic right ventricle, were subjected to total cavopulmonary connection . Eight cases underwent the operation under cardiopulmonary bypass and 7 of whom under no cardiac clamp. Seven cases received cavopulmoanry anastomosis by flaring method and one case by end side anastomosis. All the patients underwent the intracardiac tunnels to drain inferior vena cava and plus 4 mm fenestration except one. The results showed that 6 patients had postoperative oxygen saturation more than 90 %, sinus rhythm, no anastomostic stoma obstruction, no flow reguigitation and CVP<16 cmH 2O. Two patients died postoperatively from high venous pressure of 18—20 cmH 2O, finally from cardiac failure and anoxima. It was concluded that TCPC was an effective treatment for complex congenital cardiac diseases, especially with ventricular maldevelopment. Intracardiac tunnel plus 4 mm fenestration and flaring cavopulmonary anastomosis could prevent the postoperative complications. Larger anastomotic stoma, venous pressure less than 16 cmH 2O and artery saturation more than 90 % might indicate excellent TCPC procedures in our experience.