Tricuspid atresia: Experience in surgical management with a modified cavopulmonary anastomosis

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Abstract
A limited experience with an initial series of nine patients operated upon for tricuspid atresia using a modified superior vena cava to right pulmonary artery anastomosis is presented. The modified technique is described and illustrated. It avoids permanent disruption of pulmonary artery continuity and the high incidence of superior vena cava syndrome. In short, the right pulmonary artery is not severed, the azygos vein is always ligated, the superior vena cava is not mass ligated and is subjected to delayed interruption. Analysis of the results shows an operative and overall mortality of 33%. The advantages of this modified surgical approach are outlined.