Extracardiac Fontan operation without cardiopulmonary bypass

Choreoathetosis developed after bilateral bidirectional cavopulmonary anastomosis in a 17-month-old boy with univentricular heart. To avoid exacerbating this neurologic problem, the Fontan operation was later completed without cardiopulmonary bypass. The left cavopulmonary anastomosis maintained pulmonary blood flow. A tube graft was anastomosed to the junction of the right cavopulmonary anastomosis. A femoral vein-to-right atrial shunt was established, the inferior vena cava divided, the cardiac end oversewn, and the noncardiac end anastomosed to the tube graft. (C) 1997 by The Society of Thoracic Surgeons.