Pulmonary blood flow distribution after the total cavopulmonary connection for complex cardiac anomalies

In total cavopulmonary connection (TCPC), anastomotic portion of the caval veins to the pulmonary artery (PA) is decided empirically based on personal experience. To compare the pulmonary flow distribution from both caval veins in various types of cavopulmonary anastomosis, intrapulmonary ventilation-perfusion distribution after TCPC was studied using lung scanning. In patients whose superior vena cava (SVC)-PA anastomosis is right side of inferior vena cava (TVC)-PA anastomosis, the blood flow distribution of right and left lungs was 57.4% : 42.6%. In patients whose SVC-PA anastomosis is left side of NC-PA anastomosis, the blood flow distribution of right and left lungs was 53.1% : 46.9%. Lung scanning with xenon-133 revealed the distribution of pulmonary blood flow in the patients after TCPC quantitatively, and in the patients whose SVC-PA anastomosis was left side to IVC-PA anastomosis, the right and left balance of the pulmonary blood flow distribution appeared to be balanced compared to the connection of opposite situation.