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Ann Thorac Surg 2006;82:350-352
© 2006 The Society of Thoracic Surgeons

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Extracardiac Fontan Procedure Bridging the Vertebra for Apico-Caval Juxtaposition

Yoichi Kawahira, MD * , Kyoichi Nishigaki, MD, Takayoshi Ueno, MD

Department of Pediatric Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan

Accepted for publication July 18, 2005.

* Address correspondence to Dr Kawahira, Department of Pediatric Cardiovascular Surgery, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojimaku, Osaka, 534-0021, Japan (Email: ykawahir{at}mac.com).

For 5 patients with univentricular heart associated with apico-caval juxtaposition, an extracardiac Fontan procedure was carried out using an artifical graft bridging the vertebra to avoid graft compression by the vertebra and the ventricle. For 2 patients representing nonconfluency between the inferior caval vein and the hepatic vein, a hand-made, shoetree graft was used. Postoperatively all patients are doing well without a stenotic venous pathway. This extracardiac operation using an artificial graft bridging the vertebra may be advantageous for univentricular heart associated with apico-caval juxtaposition to prevent a postoperative stenotic venous pathway.






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Copyright © 2006 by The Society of Thoracic Surgeons.