Surgical repair of tricuspid atresia has been carried out in three patients; two of these operations have been successful. A new surgical procedure has been used which transmits the whole vena caval blood to the lungs, while only oxygenated blood returns to the left heart. The right atrium is, in this way, `ventriclized', to direct the inferior vena caval blood to the left lung, the right pulmonary artery receiving the superior vena caval blood through a cava-pulmonary anastomosis. This technique depends on the size of the pulmonary arteries, which must be large enough and at sufficiently low pressure to allow a cava-pulmonary anastomosis. The indications for this procedure apply only to children sufficiently well developed. Younger children or those whose pulmonary arteries are too small should be treated by palliative surgical procedures.

https://thorax.bmj.com/content/thoraxjnl/26/3/240.full.pdf

Surgical repair of tricuspid atresia

IN the first publication of this series of papers attention was called to the need of a method for the direct delivery of venous blood into the pulmonary arterial circulation1 The congenital anomalies of the heart that might be remedied from this operation are characterized by malfunction of the right atrium or right ventricle or both More specifically, the cardiac conditions that would benefit from circulatory bypass of the right side of the heart include stenosis or atresia of the tricuspid and pulmonary outflow tracts, Ebstein's anomaly, single ventricle, bilocular heart and transposition of the great vessels with an associated   

Circulatory Bypass of the Right Side of the Heart

Further experiments on long term survivors after circulatory bypass of the right side of the heart.

Two technical modifications to the modified Fontan procedure are presented. Systemic venous to pulmonary artery continuity is achieved by superior vena cava (SVC) division and end to side anastomosis to the right pulmonary artery (RPA), particularly following a right Blalock shunt, or by RPA division and anastomosis to the SVC, particularly in the presence of RPA stenosis.



Intra-atrial partitioning is achieved by a systemic venous baffle rather than a pulmonary venous baffle. This is particularly useful in the presence of left atrioventricular valve atresia, but may be a preferable technique with double-inlet single ventricle or single ventricle with common AV valve.



These techniques were applied successfully to 10 of 12 children with various forms of single ventricle, including 5 with left AV valve atresia or stenosis.

Modified Fontan procedure: atrial baffle and systemic venous to pulmonary artery anastomotic techniques.

https://www.annalsthoracicsurgery.org/article/S0003-4975(03)00450-8/pdf

Pulmonary arteriovenous malformations after cavopulmonary anastomosis.

Circulatory By-Pass of the Right Heart. I. Preliminary Observations on the Direct Delivery of Vena Caval Blood into the Pulmonary Arterial Circulation. Azygos Vein-Pulmonary Artery Shunt

William W. L. Glenn

Papers

Circulatory By-Pass of the Right Heart. I. Preliminary Observations on the Direct Delivery of Vena Caval Blood into the Pulmonary Arterial Circulation. Azygos Vein-Pulmonary Artery Shunt

Fever, splenomegaly, lymphocytosis and eosinophilia.

The digital exploration of the ventricular chambers of the heart through a rubber diverticulum.