A case of total cavopulmonary connection by utilization of coronary sinus as a hepatic venous return
Koide, M.; Sakai, A.; Iwata, Y.; Sanae, T.; Kunii, Y.; Moriki, N.; Ayusawa, Y.; Seguchi, M.
Kyobu Geka. Japanese Journal of Thoracic Surgery 53(11): 966-968
2000
ISSN/ISBN: 0021-5252 PMID: 11048452 Document Number: 523495
A 2-year-old boy with polysplenia, double outlet right ventricle after pulmonary banding and unilateral bidirectional shunt was operated on. A modified total cavopulmonary connection was done by utilization of coronary sinus as a retrograde route for the hepatic venous return. Left SVC was transected and its distal end was anastomosed to the left pulmonary artery after PA angioplasty. An equine pericardial patch was placed over the ostia of the hepatic vein and coronary sinus. Two ostia of the coronary veins were excluded from the created route. The proximal end of the left SVC was anastomosed to the inferior side of the left pulmonary artery. Postoperative course was uneventful. The postoperative angiogram showed smooth hepatic venous return through the coronary sinus and no pressure gradient was recorded between hepatic vein and pulmonary artery.