Total Cavo-pulmonary Anastomosis in Complex Congenital Cardiac Anomalies

Total cavo-pulmonary anastomosis, defined as a modification of the Fontan procedure, was done to three congenital cardiac cases. The first patient had left atrial isomerism, levocardia, double vena cava superior, double outlet right ventricle, atrial septal defect, ventricular septal defect and pulmonary stenosis. The second patient had d-transposition of the great arteries, atrial septal defect, ventricular septal defect, pulmonary stenosis and hypoplastic right ventricle. The third patient had d-transposition of the great arteries, atrial septal defect, ventricular septal defect and pulmonary stenosis. In all three patients the criteria for this procedure were present. Significant clinical and hemodynamic postoperative improvement occurred in all three patients. We believe that successful results will be obtained particulary in patients, in whom their morphology is well described and hereby qualify to be treated surgically by total cavo-pulmonary anastomosis.