We reviewed our experiences on 33 patients who underwent a bidirectional cavopulmonary shunt (BCPS) from February 1992 to July 1994. There were 19 male and 14 female patients, and their weight ranged from 4.4 to 13.3kg (mean weight 8.4±2.9kg).
The
age
ranged from 2 to 55 months (mean age 16.7±15.5 months). Their diagnosis included single ventricle group in 16, unbalanced ventricles in 8 whose associated anomalies were double outlet right ventricle, transposition of great arteries and total
anomalous
pulmonary venous return, tricuspid atresia in 7, hypoplastic left heart syndrome in 1 who underwent a Norwood procedure and double outlet right ventricle with pulmonic stenosis and tricuspid stenosis in 1 who underwent bivetricular repair. Among
them 10
patients had received other palliative operation before (Norwood procedure 1, pulmonary artery banding 3, modified Blalock-Taussig shunt 6).
The BCPS operations were performed under the cardiopulmonary bypass. 16 patients underwent unilateral BCPS and 17 patients who had bilateral SVC underwent bilateral BCPS. There patients whose associated anomalies were interruption of IVC
underwent
total
cavopulmonary shunt.
There were 5 operative deaths (mortality rate 15.1%) and 2 late deaths. The risk factor for the operation was high mean pulmonary artery pressure (p value<0.05). the survivors showed good postoperative course and their postoperatiove oxygen
saturation
was increased significantly compared to that of preoperative status (p value<0.05).
Conclusively, BCPS operation is effective and safe palliative procedure for the many cyanotic complex congenital anomalies with decreased pulmonary blood flow especially for the patients who have the high risk factors for Fontan operations.
(Korean J Thorac Cardiovasc Surg 1995;28:759-65)
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