bidirectional cavopulmonary anastomosis(English)

• considered in some patients to provide RV volume or pressure offloading. Some advocate routine use of BCPS secondary to the underlying RV myopathy, whereas others use it selectively in patients with severe RV enlargement or dysfunction. BCPS is generally feasible in EA, even in a setting of moderate LV dysfunction (LVEF 35% to 40%) because pulmonary hypertension is rare; however, caution must be used before application in this setting. Indications for the use of BCPS include RV EDVi >250 mL/m2, RVEF <25%, cardiothoracic ratio >65%, small and D-shaped LV, postrepair right atrial pressure–to–left atrial pressure ratio >1.5:1. Other indications include reduction of tension on complex TV repair and postrepair TV stenosis with a mean gradient >8 to 10 mm Hg. Contraindications include mean pulmonary artery pressure >20 mm Hg, pulmonary arteriolar resistance >4 Woods units, LV EDP or left atrial pressure >12 mm Hg, and significant pulmonary artery hypoplasia. An alternative is atrial septal fenestration by subtotal ASD closure or no closure of a PFO
• ASD, BCPS, CTR, EA, EDP, EDVI, LV, LVEF, PFO, RV, RVEF, TV
• Congenital disorders, Cardiology, Surgery
• https://doi.org…-6929-1.00043-5