Background: Due to large variability of the anatomy and associated lessons to the univentricular heart, there are many different techniques to perform the total cavopulmonary connections (TCPC). In this study we present three variations of TCPC procedure.
Patients: Between 1990 to 2008, 64 patients, age: 2 to 14 years (M= 4.2), Female: 51%, were operated. The cardiac malformation were: Tricuspid atresia, 25 (39.1% cases, Common Ventricle, 19 (29.6%) cases, Pulmonary atresia w/ intact ventricular septum, 15 (23.5%) cases, Ebstein anomaly, 5 (7.8%) cases. Three techniques were employed: G1- Intraatrial tunnel, 41 (64.1%) cases; G2- One and a half ventricle operation, 16 (25 %) cases and G3- Kawashima operation, 7 (10.9%) cases. Fifty two (81.2%) patients had bidirectional cavopulmonary connection (BCPC). In the G1, the interaatrial tunnel was performed with a thin or tubular bovine pericardio and in the G2, the right ventricle outlet tract, was reconstructed with suine pulmonary prosthesis.
Results. There were 4 (6.2%) hospital death and 1 (1.5%) late death. One (1.5%) case was submitted to reoperation, for substitution of the pulmonary prosthesis. Fifty nine (92.1%) surviving patients were followed up from 6 to 192 months and all are free of reoperation.
Conclusion: Early unloading of the functional univentricular heart by means of BCPC,
allow a good condition to completion to TCPC. The mid- term results of one and a half ventricle repair, seem to be acceptable. These three procedures can be a good alternative to TCPC repair in suitable patients.