Anastomose cavo-pulmonar total sem uso de material protético

the authors describe two cases (one tricuspid atresia without tga or pulmonary stenosis, but with a restrictive ivc: the second of an ebstein disease) of total cavo-pulmonary anastomosis using only the tissue of the atrial wall, avoiding any prosthetic material. both cases were done under cardiopulmonary bypass and cold blood cardioplegia. a flap of the right atrial wall was used to re-direct the blood flow. pleural effusion in one patient and complete av block in the other were the complications found. they conclude that right intra-atrial tunneling for total cavo-pulmonary anastomosis, avoiding the use of any foreign material is feasible, thus diminishing the possible late risks (calcification, embolization, retraction) of prosthetic materials.