Ann Thorac Surg 2002;73:1280-1281
© 2002 The Society of Thoracic Surgeons
Original article: cardiovascular
Invited commentary
Christopher A. Caldarone, MDa
a University of Iowa and Clinics 200 Hawkins Dr, 1616B JCP Iowa City, IA 52242 USA
e-mail: chris-caldarone@uiowa.edu
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Introduction
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Surgical palliation for patients with right atrial isomerism requiring a total cavopulmonary connection presents a formidable technical challenge due to the anatomic variability described in the present report of Aeba and colleagues. Separate orifices for the hepatic veins and inferior vena cava, a single orifice for entry of the pulmonary veins into the left atrium after surgical repair of anomalous venous drainage, and the relative location of the atrioventricular valve comprise the obstacles which must be circumvented to create unobstructed flow from the hepatic veins and inferior vena cava to the pulmonary artery while maintaining unobstructed flow between the pulmonary veins and the atrioventricular valve.
Although the concept of creating an unobstructed connection between the hepatic veins/inferior vena cava and the pulmonary artery is simple, the hemodynamic sequelae are complex. . . . [Full Text of this Article]
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Copyright © 2002 by The Society of Thoracic Surgeons.