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Ann Thorac Surg 1989;47:415-420
© 1989 The Society of Thoracic Surgeons
Department of Pediatric Cardiac Surgery, Bambino Gesú Hospital, Rome, Italy
Accepted for publication September 21, 1988.
* Address reprint requests to Dr Marcelletti, Dipartimento Medico-Chirurgico di Cardiologia Pediatrica, Ospedale "Bambino Gesú," Piazza S. Onofrio 4, 00165 Roma, Italy.
A standard Glenn anastomosis between the superior vena cava and the right pulmonary artery has been the accepted mode of treatment for patients with complex cyanotic congenital heart disease. We report our experience in 18 patients with such disease who underwent a bidirectional cavopulmonary shunt because of increasing cyanosis and growth cessation. All patients were considered less than "ideal" candidates for a Fontan procedure. We divided the patients into two groups: group 1 had azygos continuation and group 2 did not. Fourteen patients required hypothermic cardiopulmonary bypass. Bidirectional pulmonary blood flow was achieved in all patients. Only 1 death occurred (group 2). The improvement in oxygen saturation and overall clinical condition of these patients, together with the low mortality and morbidity, is encouraging. However, long-term follow-up is mandatory for a comprehensive evaluation of this surgical approach as definitive palliation or as a first stage for a Fontan operation.
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