Abstract
Background: The purpose of this study was to ascertain the effectiveness of total cavopulmonary connection (TCPC) by reviewing the midterm outcomes of TCPC conversion operations.
Method and Patients’ Background: We analyzed data for 35 patients who underwent TCPC conversion operations performed between January 2004 and December 2013 in our institute. No patients showed medication-refractory congestive cardiac failure, severe renal failure, or irreversible liver cirrhosis. Eighteen patients (51.4％) underwent additional surgical procedures, including arrhythmia surgery.
Results: Postoperative complications were observed in 25 patients (71.4％), with the most frequent complication being supraventricular tachyarrhythmia (n＝10). There was one case of in-hospital death and no deaths after discharge. The actuarial freedom from cardiac events was 75.0％ at 5 years after discharge. New York Heart Association functional class and the incidence of supraventricular tachyarrhythmia significantly improved after TCPC conversion. However, simultaneous arrhythmia surgery did not improve the incidence of supraventricular tachyarrhythmia during hospitalization or after discharge. Cardiac catheter investigation after TCPC conversion revealed a significant improvement in cardiac index (from 2.19±0.51 L/min/m2 to 2.85±0.84 L/min/m2, p＜0.01) and central venous pressure (from 13.1±3.0 to 11.4±3.4, p＜0.02).
Conclusion: TCPC conversion is safe and symptomatically effective for patients whose organ functions were preserved. TCPC conversion may contribute to improvement of patients’ blood circulation and general condition.
