Surgical management of total cavopulmonary connection procedure in functional single ventricle with separate hepatic venous drainage
- VernacularTitle:功能性单心室合并肝静脉单独回流入心房的全腔静脉-肺动脉连接术
- Author:
Xiaobing LIU
1
,
2
;
Jianzheng CEN
1
,
2
;
Jimei CHEN
1
,
2
;
Shusheng WEN
1
,
2
;
Gang XU
1
,
2
;
Hailong QIU
1
,
2
;
Juemin YU
1
,
2
;
Jian ZHUANG
1
,
2
Author Information
1. Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People'
2. s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P. R. China
- Publication Type:Journal Article
- Keywords:
Separate hepatic venous drainage;
total cavopulmonary connection;
functional single ventricle;
heterotaxy syndrome
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(05):597-601
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the management of hepatic vein (HV) in patients with functional single ventricle (FSV) and separate hepatic venous drainage (SHVD) undergoing total cavopulmonary connection (TCPC) and evaluate this kind of surgery. Methods The clinical data of 32 consecutive patients with SHVD who underwent modified TCPC operation from August 2005 to January 2017 in our center were retrospectively analyzed. There were 25 males and 7 females with an average age of 2-19 (8.0±5.0) years and body weight of 11-66 (25.4±15.8) kg. Results There were 20 patients with heterotaxy syndrome and 12 patients with other types of FSV. SHVD was diagnosed preoperatively in 27 patients, among whom 20 patients were connected by intra-extracardiac Gore-Tex conduit, and the other 7 patients were connected by extracardiac Gore-Tex conduit. Because of the missed diagnosis of SHVD, the other 5 patients showed severe decrease of blood oxygen saturation in the early postoperative period and underwent re-operation soon. The postoperative blood oxygen saturation was 92.0% (90.0%, 96.0%), central venous pressure was 10-23 (15.5±3.5) mm Hg, mechanical ventilation assisted time was 16.0 (7.5, 24.0) h, and ICU stay time was 3.0 (2.0, 5.5) d. There were 3 early and 1 late deaths. Conclusion Intra-extracardiac conduit is an effective and feasible modified TCPC operation for patients with FSV and SHVD, while the surgical details need to be formulated in combination with individual anatomical structure. Preoperative missed diagnosis of SHVD must be avoided. Otherwise, after TCPC, a large amount of stealing blood from HV with low circulation pressure into atrium would lead to unacceptable hypoxemia.
