Snir E, Raanani E, Birk E, Zeevi B, Berant M, Vidne B A
Departments of Cardiothoracic and Pediatric Cardiology, Beilinson Medical Center, Petach Tikva, Israel.
J Cardiovasc Surg (Torino). 1994 Dec;35(6 Suppl 1):141-4.
We reviewed our experience with 40 patients who had undergone total cavopulmonary connection (TCPC) during the past three years. Thirty-one patients had functional single ventricle; only 8 of these with tricuspid atresia, five patients had complex forms of double outlet right ventricle (DORV), and four complex A-V canal. Previous palliative procedures, mostly systemic-pulmonic shunts, were performed in 34 patients. Concomitant procedures were required in 18 patients, mainly reconstruction of distorted pulmonary arteries. A subgroup of 14 high risk patients, that did not fulfil the classical Fontan criteria, underwent 4 mm fenestration of the intra-atrial baffle. There were three (7.5%) early postoperative deaths which occurred in the higher risk group (fenestrated group). However, the remaining patients were all in functional class I or II. Total cavopulmonary connection provides reasonably good definitive palliation for patients with single ventricle physiology. Fenestration of the intra-atrial baffle increases the number of candidates suitable for the Fontan procedure, although the exact inclusion criteria for these patients has yet to be defined.
我们回顾了过去三年中40例接受全腔静脉肺动脉连接术（TCPC）患者的经验。31例患者为功能性单心室；其中仅8例为三尖瓣闭锁，5例为复杂形式的右心室双出口（DORV），4例为复杂房室管畸形。34例患者曾接受过姑息性手术，主要是体肺分流术。18例患者需要同期手术，主要是对扭曲的肺动脉进行重建。14例不符合经典Fontan标准的高危患者亚组接受了4毫米的房间隔造瘘术。术后早期有3例（7.5%）死亡，均发生在高危组（造瘘组）。然而，其余患者均为心功能I级或II级。全腔静脉肺动脉连接术为单心室生理的患者提供了相当不错的最终姑息治疗。房间隔造瘘术增加了适合Fontan手术的患者数量，尽管这些患者的确切纳入标准尚未确定。
