We describe our experience with a 15-year-old girl who had initially undergone conversion to the Fontan circulation by construction of a fenestrated lateral tunnel as the culmination of therapy for a cardiac diagnosis of transposition with a remote midmuscular ventricular septal defect and subpulmonary stenosis resulting in hypoplasia of the morphologically left ventricle. Subsequent failure of the Fontan circulation had resulted in signs of failure of the right heart, so revision was achieved by placing an extracardiac conduit between the inferior caval vein and the undersurface of the bifurcation of the pulmonary arteries. During the postoperative period, we used cardiac computed tomography to evaluate the patency of the extracardiac conduit.
Figure 1(arrow) demonstrates a cross-sectional view of the patent extracardiac conduit, while the conduit is shown in coronal view in
Figure 2(arrow). In
Figure 3, we provide a three-dimensional reconstruction that clearly visualizes the external appearance of the entire Fontan circuit (arrow).
Figure 1
Figure 2
Figure 3
Our experience highlights again the ability of cardiac computed tomography to delineate, in a non-invasive fashion, the internal and external three-dimensional characteristics of surgically created cardiac circuits, the technique having the added advantage of providing the ability to evaluate extracardiac pathology.
