Extracardiac Conduit versus Lateral Tunnel for Total Cavopulmonary Connections
Sukasom Attanavanich MD*, Panuwat Lertsithichai MD*
Affiliation : * Cardiovascular Thoracic Unit, Division of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok
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.
Materials and Methods : 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
