Modified total cavopulmonary connection operation without cardiopulmonary bypass

Objective: To report the modified total cavopulmonary connection (TCPC) operation without cardiopulmonary bypass for treating functional single ventricle. Methods: Modified TCPC was performed in three patients with functional single ventricle. Superior vena cava (SVC) and inferior vena cava (IVC) were cannulated and connected with right atrial cannulation to drain the systematic blood into right atrium. A side-biting clamp is used to occlude the right pulmonary artery (RPA). The distal end of SVC was connected with the upper edge of RPA with the anastomosis orifice near the left side, and the distal end of IVC was directly connected with the lower edge of RPA using extracardiac conduit. Stenosis pulmonary orifice was closed by suture. Results: There was no early and late postoperative mortality. One patient had low cardiac output syndrome and pleural effusion. The patients had SatO_2 0.94～0.97 while inspiring air postoperatively. The patients were followed up from 1 month through 3 months, and NYHA heart function class I was in 2 patients and class II in 1. Conclusion: Modified total cavopulmonary connection operation without cardiopulmonary bypass is an effective procedure to treat functional single ventricle.