| Successful Conversion of Atriopulmonary
Anastomosis to Total Cavopulmonary Connection Using Autologous
Atrial Flap |
(Department of Cardiovascular Surgery, Nakadohri
General Hospital, Akita, Japan)
| Noriyasu Kawada |
Tadashi Okubo |
Yoshiyuki Kamigaki |
| Hajime Kin |
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We report a successful conversion
of atriopulmonary anastomosis to total cavopulmonary connection
using an autologous atrial flap. A 28-year-old man after atriopulmonary
anastomosis with a valve conduit performed under a diagnosis
of double inlet left ventricle (DILV), d-TGA, was admitted with
moderate cyanosis and atrial fibliration which he had suffered
since age 25. Cardiac catheterization and ultrasonic cardiography
revealed regurgitation at the site of tricuspid patch closure,
and atrial dilatation. We excised the regurgitated patch, closed
tricuspid valve leaflets, and made an atrial lateral tunnel using
an autologous atrial flap. In particular we took care of crista
terminalis, sinus node arteries, and sinus node at the operation.
He recovered his sinus rhythm on the first operative day, but
secondary atrial fibrillation developed. Four months later, catheterization
showed good hemodynamics with low central venous pressure, and
no obstruction of the atrial tunnel.
Jpn. J. Cardiovasc. Surg. 30: 259-261 (2001) |
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