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Ann Thorac Surg 2004;78:727-729
© 2004 The Society of Thoracic Surgeons

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Total extracardiac cavopulmonary connection: an alternative technique of fenestration

Manoj Purohit, Mcha, Marco Ricci, MDa, Marco Pozzi, MDa*

a Department of Paediatric Cardiac Cardiology, Royal Liverpool Children's NHS Trust, Liverpool, United Kingdom

Accepted for publication April 8, 2003.

* Address reprint requests to Dr Pozzi, Department of Paediatric Cardiac Surgery, Royal Liverpool Children's NHS Trust, Liverpool L12 2AP, UK
e-mail: mpozzi76{at}hotmail.com

Fenestrating an extracardiac conduit used for total cavopulmonary connection normally requires an additional incision on the right-sided atrium and is time consuming. Herein we describe an alternative technique that may be used to facilitate this process, which consists of creating the fenestration by using part of the atrial incision resulting from the disconnection of the inferior vena cava from the right atrium. The advantages of this technique are avoidance of an extra incision and suture line on the atrium, and the ease of construction. This may be especially useful in patients with heterotaxy syndromes with mesocardia or dextrocardia, in whom the atrial mass is displaced posteriorly and can be difficult to reach. Closure of the fenestration can be easily performed at a later stage in the cardiac catheterization laboratory by using a septal occluding device.






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