Aortic Arch Homograft Reconstruction of Nonconfluent Pulmonary Arteries During Extracardiac Fontan

Abstract

Reconstruction of nonconfluent pulmonary arteries during Fontan completion is a challenging technical issue. In this case report, we describe the use of an aortic homograft, including the aortic arch, to complete a Fontan and reconstruct the pulmonary artery confluence in a child with discontinuous pulmonary arteries and bilateral superior caval veins who had undergone bilateral unidirectional Glenn palliation. The configuration of the aortic homograft was ideal to ensure laminar flow from the inferior vena cava to both pulmonary arteries and in maintaining durable elastance posterior to the native aorta.