[A case report of complex cardiac malformation treated with total cavopulmonary connection after pulmonary artery banding].Nihon Kyobu Geka Gakkai Zasshi. 1993 Nov; 41(11):2261-5.NK
A two-year-old boy with cardiac malformation including hypoplastic right ventricle, severe stenosis of the tricuspid valve, atrial primum defect and ventricular septal defect underwent total cavopulmonary connection after pulmonary artery banding, which was done to tract cardial failure at six months after birth. Under cardiopulmonary bypass, an intraatrial cavocaval channel was constructed with a prosthetic patch of expanded polytetrafluoroethylene (EPTFE). The superior vena cava was transected and each end of the superior vena cava was anastomosed to the pulmonary artery in an end-to-side fashion. Pulmonary artery pressure registered 15 mmHg on cardiac catheterization after operation, and angiography showed smooth blood flow to the pulmonary artery from the vena cava. We suggest that a Fontan-type operation could be indicated for the patients younger than 4-year-old having acceptable pulmonary resistance if the symptoms of hemoconcentration and hypoxia are life-threatening.