Pulmonary venous obstruction after extracardiac total cavopulmonary connection in right atrial isomerism
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ORIGINAL ARTICLE
Pulmonary venous obstruction after extracardiac total cavopulmonary connection in right atrial isomerism Yosuke Kugo1 · Shigemitsu Iwai1 · Kazuhiko Ishimaru1 · Sanae Yamauchi1 · Moyu Hasegawa1 · Koji Miwa1 · Hiroaki Kawata1 Received: 10 September 2019 / Accepted: 2 February 2020 © The Japanese Association for Thoracic Surgery 2020
Abstract Background Patients with functional single ventricle and right atrial isomerism (RAI) often have multiform cardiac pulmonary venous (PV) connection, which could be a risk factor for pulmonary venous obstruction (PVO) after extracardiac total cavopulmonary connection (EC-TCPC) owing to compression of the conduit. Objective To investigate the anatomical risk factors for PVO after EC-TCPC in RAI. Methods Twenty-nine patients with RAI without extracardiac total anomalous pulmonary venous connection were enrolled. No patients had PVO before EC-TCPC. A total of 14 and 15 patients had PV orifices ipsilateral and contralateral to the extracardiac conduit, respectively. The former 14 patients were assigned to two groups based on development of PVO after EC-TCPC (groups O and N). The pre- and post-operative cardiac morphologies and their relationship with the conduit were compared. Results After the EC-TCPC, the pressure gradients between the atrium and the PV were 5.0 ± 2.5 and 0.44 ± 0.2 mmHg in groups O and N, respectively (p
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