J Med Assoc Thai 2007; 90 (11):2513

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Extracardiac Conduit versus Lateral Tunnel for Total Cavopulmonary Connections
Attanavanich S Mail, Lertsithichai P

Objective: Compare the surgical outcomes of the lateral tunnel and the extracardiac conduit total cavopulmonary connections at a single center during a 10-year period.
Material and Method: From October 1995 through October 2005, 27 total cavopulmonary connections (TCPC) were performed: fourteen patients were the lateral tunnel and thirteen patients were the extracardiac conduit. Prior superior cavopulmonary connective surgery and fenestration surgery were done more often in the group with extracardiac conduit.
Results: Operative mortality was 29% in the lateral tunnel and no operative mortality in the extracardiac conduit (p < 0.05). The cause of deaths in three patients was significant AV valve regurgitations and one was small pulmonary artery index. All patients in both groups were in NYHA class I and 2 and no patients with supraventricular arrhythmias were detected in the two groups during the follow-up period. There was only one patient in the lateral tunnel who developed thromboembolism from irregular warfarin taking.
Conclusion: The extracardiac conduit had lower mortality than the lateral tunnel. However, there was no difference in early and mid-term complications.

Keywords: Fontan procedure, Tricuspid valve, Atresia


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