TCPC Fontan Operation

What is the Total Cavo-Pulmonary Connection (TCPC) Fontan ?

A group of surgeons in the United Kingdom has come up with a detailed computer simulation program, and this software allows creation of a computer generated image of the heart after the different modifications of the Fontan operation, to allow study of blood flow patterns with each. The type that allows smooth flow will be preferred because less energy is wasted by "turbulence", and allows more energy to be used for achieving lung blood flow.

Based on their experimental studies performed earlier, this group suggested the idea of a LATERAL TUNNEL FONTAN repair. In this, a "tunnel" is created within the right atrium using an artificial fabric patch. The tunnel links the superior and inferior vena cava (SVC and IVC) to each other. The tunnel is then connected to the pulmonary artery. Because of this, the operation is also called TOTAL CAVO-PULMONARY CONNECTION - or TCPC.

The advantage with this technique is that blood flow is laminar, and energy loss due to turbulent flow is least, and thus improving lung blood flow.

Later improvements of the TCPC operation have allowed

• Construction of the tunnel with the patient's own heart tissue, avoiding use of artificial fabric
• Creating the tunnel "outside" the right atrium, avoiding an incision in the atrium
• Performance of the operation without using the heart lung machine - almost like a closed heart operation

To learn about the modified Fontan operation called the Fenestrated Fontan, read the next article in this series.