Fontan operation for patients with complex anatomy: the intra-atrial conduit technique.

The extracardiac conduit type of total cavopulmonary connection (TCPC) is the most common variation of the modified Fontan operation in current use. For patients with some forms of complex anatomy (eg, dextrocardia in situs solitus or asplenia syndrome), we have adopted a different technique: interposition of an intra-atrial conduit between the inferior vena cava (IVC) and the superior vena cava-right pulmonary artery (SVC-RPA) connection. We report our experience with six patients.

Giant left ventricular aneurysm and aortic stenosis in a newborn.

Congenital ventricular aneurysm (CVA) is a rare, poorly understood and potentially lethal cardiac anomaly. We report a neonatal case, remitted to our hospital due to a cardiogenic shock. Echocardiographic study revealed a severe aortic stenosis and a giant left ventricular aneurysm. Surgical intervention was carried out with extracorporeal circulation support, but without cardiac arrest, achieving aortic valvulotomy and aneurismal resection. The postoperative course was uneventful during the first 24 h, but on the second day, the patient presented a sudden unexpected cardiac arrest, not responding to the resuscitation manoeuvres.