Bidirectional Cavopulmonary Shunt in Patients With Anomalies of Systemic and Pulmonary Venous Drainage Doff B McElhinney, MS, V.Mohan Reddy, MD, Phillip.

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Presentation transcript:

Bidirectional Cavopulmonary Shunt in Patients With Anomalies of Systemic and Pulmonary Venous Drainage Doff B McElhinney, MS, V.Mohan Reddy, MD, Phillip Moore, MD, Frank L Hanley, MD The Annals of Thoracic Surgery Volume 63, Issue 6, Pages 1676-1684 (June 1997) DOI: 10.1016/S0003-4975(97)00364-0

Fig. 1 (A) Anatomy of patient 17, who had neither left nor right atrial isomerism. (B) Technique of repair, as described in text. (Note: This and subsequent figures may not accurately reflect the anatomy of the atrial appendages in the patients represented; atrial appendage anatomy is mentioned in the figure legends for the sake of clarity.) (Ao = aorta; LA = left atrium; LPA = left pulmonary artery; LPV = left pulmonary vein; LSVC = left superior vena cava; RA = right atrium; RPA = right pulmonary artery; RPV = right pulmonary vein; RSVC = right superior vena cava.) The Annals of Thoracic Surgery 1997 63, 1676-1684DOI: (10.1016/S0003-4975(97)00364-0)

Fig. 2 (A) Anatomy of patient 15 (right atrial isomerism). (B) Technique of repair, as described in text. (C) Alternative technique of repair, with anastomosis of the anomalous LPV to the atrial stump of the LSVC, effectively conserving suture line. (Abbreviations are as in Fig. 1.) The Annals of Thoracic Surgery 1997 63, 1676-1684DOI: (10.1016/S0003-4975(97)00364-0)

Fig. 3 (A) Anatomy of patient 4 (right atrial isomerism). (B) Technique of repair, as described in text. (C) Alternative technique of repair, with anastomosis of the anomalous RPV to the cardiac stump of the superior vena cava, effectively conserving suture line. (LIV = left innominate vein; other abbreviations are as in Fig. 1.) The Annals of Thoracic Surgery 1997 63, 1676-1684DOI: (10.1016/S0003-4975(97)00364-0)

Fig. 4 Actuarial survival curves for all patients undergoing bidirectional cavopulmonary shunt during the study period, patients with anomalies of systemic or pulmonary venous drainage (ASVD/APVD), and patients with heterotaxy syndrome. Differences in survival were not significant between groups. The Annals of Thoracic Surgery 1997 63, 1676-1684DOI: (10.1016/S0003-4975(97)00364-0)