Objective: To compare the outcome of one stage and staged total cavopulmonary connection(TCPC) in more than three-years-old patients.
Materials and Methods: Retrospectively analyzed consecutive 114 over-three-years-old patients with functional single ventricle (SV) enrolled in Fuwai Hospital. All the patients were divided into two groups: group A (n=36) underwent staged TCPC ; group B (n=78) recieved one-stage TCPC. Group A were performed glenn procedure firstly because of high risk factor. Glenn procedure age were 5.9 ± 2.8 years, and the TCPC age were 8.3 ± 3.1 years . There was a interval of 26.0 ± 32.0 months between the two procedures. Mean pulmonary arterial pressure after Gleen procedure was 14.9 ± 3.1mmHg. 16 had fenestration. The TCPC age of were 9.4±5.6 years . 35 of Group B had fenestration.
Results: The mortality of group A was 8.3%(3/36). One directly died of low cardiac output syndrome(LCOS) , the other 2 died of LCOS-related complications. 5(31.3%) with drainage for more than 14 days in fenestration patients, 10(50%) in no fenestration patients. The mortality of Group B was 3.8% (3/78). two death were LCOS-related causes and 1 because of neurological complication. 10(28.6%) with drainage for more than 14 days in fenestration patients, 19(44.2%) in no fenestration patients. The Mortality of group A was higher than that of group B.
Conclusion Functional SV patients with high-risk factors can got better outcome by staged TCPC in more than three-years-old patients. Planned fenestration reduced the amount of drainage.