The Clinical Application of Cava-Pulmonary Anastomosis

¹ Department of Thoracic and Cardiovascular Surgery, Charlotte Memorial Hospital

The hemodynamic effects of superior vena cava to right pulmonary artery anastomosis are briefly presented. This operation may be beneficial in congenital heart conditions in which there is an obstruction of blood flow in the right heart or pulmonary circuit or because of abnormal routing, or when the venous blood flow to the lungs is decreased.

This procedure has been successfully applied in tricuspid stenosis, non-functioning right ventricle, peripheral stenosis of the pulmonary artery, Ebstein's disease, transposition with pulmonary stenosis, and tetralogy of Fallot. The operative results in these conditions have been satisfactory.

The merits and disadvantages, as well as possible future applications of this operation, are briefly discussed. The main contraindications for this procedure are: blood vessels too small for anastomosis and increased pulmonary vascular resistance. This procedure should not be applied if the anomaly can be completely repaired with a reasonable operative risk.