Background: In this article, we present the results of an offpump cavoatrial shunt technique to creat a cavopulmonary bidirectional anastomosis.

Methods: Thirty-eight consecutive patients (18 boys, 20 girls; mean age 14.9±16.8 months; range 4 months to 2.5 years) with univentricular heart physiology underwent an off-pump cavopulmonary bidirectional anastomosis between April 2003 and November 2012. The mean weight during surgery was 8.3±3.6 kg. The mean preoperative oxygen saturation and pulmonary artery pressure were 70.7±9.4% and 14.0±3.8 mmHg, respectively.

Results: There was no surgery-related mortality. The mean superior vena cava clamping time and the mean vena cava pressure during clamping were 24.3±4.7 minutes and 26.9±5.5 mmHg, respectively. There were no postoperative neurological complications or dysrhythmias. The mean postoperative saturation was 85.9±5.9%. There were four postoperative deaths. The mean length of intensive care unit stay was two days. Follow-up echocardiography showed functioning cavopulmonary bidirectional anastomosis without any obstruction.

Conclusion: The cavopulmonary bidirectional anastomosis without cardiopulmonary bypass with the support of a cavoatrial shunt is a feasible and safe method. It also eliminates the adverse effects of cardiopulmonary bypass.

Keywords : Cardiopulmonary bypass; cavopulmonary bidirectional anastomosis; single ventricle