Outcome after Univentricular Surgery in A National Center of Developing Country

Goal of cavopulmonary bypass in patients with univentricular heart, is the separation of systemic and pulmonary circuit and facilitate transpulmonary circulation with pressure differences between systemic venous bed and the main ventricle. There are several controversies about the indications, techniques and timing of the cavopulmonary bypass. The application of intratrial and extracardiac bypass in the William Soler Pediatric Cardiocenter began in 1992. A prospective cohort study was carried out from 1992 to 2011 in 92 patients, 39 with the extracardiac technique and 53 with the intratrial technique in order to assess the evolution and identify risk factors for complications. There were no significant differences in early morbidity and mortality. Surgery at one time is a risk factor for hospital mortality. No risk factors were identified for persistent pleural effusions, while postoperative atrioventricular insufficiency was identified for postoperative arrhythmia. Post-surgical ventricular dysfunction is related to the decrease in the ventricular mass index, predisposes to protein-losing enteropathy and decreased functional capacity. All complications first appeared in a greater number of patients with intratrial bypass but without significant differences. The extracardiac variant exposes a lower probability of late complications.

Keywords: Univentricular, Congenital heart diseases, Fontan.