Abstract:

Objective To summarize the clinical experience of treating complex congenital heart diseases by the staged total cavopulmonary connection (CPC) without cardiopulmonary bypass (CPB). Methods Twenty nine patients with complex congenital heart diseases underwent staged TCPC without CPB. Among them, 11 cases had functional univentricle with pulmonary stenosis; 13 cases had tricuspid atresia with hypoplasia of right ventricle; 2 cases had Ebstein's anomaly with hypoplasia of right ventricle; and 3 cases had total atrioventricular septum defect with double outlet right ventricle and pulmonary stenosis. Six cases with left superior vena cava received the first stage operation of bilateral BDG and after twenty three months, they received the TCPC without CPB. Results There was no postoperative death. All patients were recovered and discharged. All patients except 7 cases were followed up for 5-10 years and there was no medium and long term death. The cyanosis of all patients was disappeared and their arterial oxygen saturation was 89%-97%. The cardiac function was class I for 18 patients and class II for 4 patients. Conclusion The staged TCPC without CPB has good outcomes with fewer complications.

Key words: heart defects, congenital, total cavopulmonary connection, off-pump