The authors describe two cases (one tricuspid atresia without TGA or pulmonary stenosis, but with a restrictive IVC: the second of an Ebstein disease) of total cavo-pulmonary anastomosis using only the tissue of the atrial wall, avoiding any prosthetic material. Both cases were done under cardiopulmonary bypass and cold blood cardioplegia. A flap of the right atrial wall was used to re-direct the blood flow. Pleural effusion in one patient and complete AV block in the other were the complications found. They conclude that right intra-atrial tunneling for total cavo-pulmonary anastomosis, avoiding the use of any foreign material is feasible, thus diminishing the possible late risks (calcification, embolization, retraction) of prosthetic materials.
Heart bypass; Heart bypass; Tricuspid atresia; Ebstein's anomaly