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Ann Thorac Surg 1994;58:1510-1514
© 1994 The Society of Thoracic Surgeons

Articles

Conversion of atriopulmonary to cavopulmonary anastomosis in management of late arrhythmias and atrial thrombosis

Jane M. Kao, MDa,b, Juan C. Alejos, MDa,b, Peter W. Grant, MDa,b, Roberta G. Williams, MDa,b, Kevin M. Shannon, MDa,b, Hillel Laks, MD*,a,b

a Division of Cardiothoracic Surgery, Department of Surgery, University of California, Los Angeles Medical Center, Los Angeles, California USA
b Division of Pediatric Cardiology, Department of Pediatrics, University of California, Los Angeles Medical Center, Los Angeles, California USA

Accepted for publication May 13, 1994.

* Address reprint requests to Dr Laks, Division of Cardiovascular Surgery, University of California-Los Angeles Medical Center, 10833 Le Conte Ave, Los Angeles, CA 90024.

The original atriopulmonary connection or "classic" Fontan operation is associated with several late complications such as arrhythmias, right atrial dilatation, and thromboembolism. This report describes our experience with 3 patients who presented with the acute onset of atrial arrhythmias and upon further evaluation were found to have significant hemodynamic lesions. After failing medical management, all 3 patients were treated successfully with surgical conversion of their atriopulmonary connection to a lateral tunnel cavopulmonary Fontan. The postoperative course of these patients was uneventful. However, long-term evaluation is needed to assess the efficacy of this technique in the prevention of postoperative morbidity.




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