The long-term outcome of extra cardiac lateral tunnel total cavopulmonary connection

Abstract Background Although early results of total cavopulmonary connection (TCPC) using an extracardiac conduit are favorable, the patients' growth leads to linearization Fontan route causing energy loss by collision blood flow from SVC and IVC, PV compression. Use oversized in young children also causes due caliber change, a risk thrombosis stagnation. We have performed TCPC with Extra Cardiac Lateral Tunnel (ECLT) technique e-PTFE patch make angled design for laminar IVC confluence, avoid change IVC-Fontan route. Purpose To clarify long-term outcome (ECLT-TCPC) patch. Methods Medical records patients who underwent staged ECLT-TCPC April 2003 March 2020 were reviewed retrospectively. The surgical consists creation PA opening connected atrial appendage free wall as floor suturing cut-open graft over anterior external right atrium 14–16 mm diameter entering ventral aspect merge angle. Sixty five included study: 46 cases functional single ventricle, 10 HLHS, 9 tricuspid atresia. Age at surgery 33.0±22.2 month weight was 11.1±3.7 kg. Preoperative catheterization data following; pressure: 10.3±4.0 mmHg, PVR: 1.9±0.65 woods. Results had one in-hospital death (1.8%) three deaths (6.2%) during follow-up period 7.3±4.3 years. Long-term complications 6 arrhythmias requiring medical or treatment. Other complication 2 thrombotic complications, 1 case hemorrhagic complication. Two re-operation TCPC: cyanosis residual shunt occlusion anticoagulant therapy usually terminated eight months after surgery. At latest follow-up, 55 (84.6%) anticoagulantion-free. one-year diameters 11.0±2.4mm anastomosis level, 10.8±2.5mm middle 10.0±2.5mm level. levels 14.9±3.4mm, 13.0±3.2mm, 13.6±4.9mm, respectively. Using normal reference, 127±35%, 123±28%, 143±44% Normal, respectively, remaining above 100%Normal. pressure gradient between 1.5±1.0mmHg no significant changes noted. Conclusion ECLT seemed acceptable. This may provide advantages maintenance design, option freedom form anticoagulation. Funding Acknowledgement Type funding sources: None.