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Ann Thorac Surg 2007;84:666-668
© 2007 The Society of Thoracic Surgeons

Case Reports

Conversion to Total Cavopulmonary Connection After Failed One and One-Half Ventricular Repair

Hideki Uemura, MD, FRCSa, Toshikatsu Yagihara, MDb,*, Iki Adachi, MDa, Koji Kagisaki, MDb, Fumiaki Shikata, MDb

a Department of Cardiothoracic Surgery, Royal Brompton Hospital, London, United Kingdom
b Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan

Accepted for publication February 23, 2007.

* Address correspondence to Dr Yagihara, National Cardiovascular Center, Japan, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan (Email: yagihara{at}hsp.ncvc.go.jp).

In 3 patients previously undergoing one and one-half ventricular repair, right ventricular dysfunction progressed for more than 10 years. Their clinical features resembled those seen in patients undergoing the atriopulmonary Fontan procedure, and reoperation was carried out for conversion to total cavopulmonary connection. Hemodynamics improved subsequent to the circulatory renewal. In 2 patients having atrial arrhythmia before conversion, the resected right atrial wall illustrated grossly abnormal histopathology. These patients suffered from persistent sinus nodal dysfunction and eventually needed pacemaker implantation. The third patient died of sepsis 4 months later.






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Copyright © 2007 by The Society of Thoracic Surgeons.