de Leval Modified Surgery

  • Bin Qiao
  • Bao Wei Shao


In 1988, de Leval proposes the conception of intra-atrial lateral tunnel Fontan circulation. All or most of the right atrium and right ventricle is put aside from the Fontan circulation. Surgery consisted of three procedures: (1) two end-to-side anastomosis were performed respectively, i.e., the divided superior vena cava to superior and inferior surface of right pulmonary artery, right atrium and right ventricle being put aside; (2) an intracardiac tunnel was constructed by using posterolateral wall of the right atrium; (3) along the two-side edge of atrial posterior wall, a hemi-pipe patch was sutured into the position that started from inferior vena cava inlet and extended upward to the anastomosis of proximal end of superior vena cava to right pulmonary artery.


  1. de Leval MR, Kilner P, Gewillig M, Bull C. Total cavopulmonary connection: A logical alternative to atriopulmonary connection for complex Fontan operations. Experimental studies and early clinical experience. J Thorac Cardiovasc Surg. 1988;96(5):682–95.PubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. and People's Medical Publishing House Co. Ltd. 2018

Authors and Affiliations

  • Bin Qiao
    • 1
    • 2
  • Bao Wei Shao
    • 3
  1. 1.Cardiovascular InstituteGeneral Hospital of Jinan Military RegionJinanChina
  2. 2.Cardiac Surgery CenterWestern District of Shandong Provincial HospitalJinanChina
  3. 3.Institute of Cardiovascular Diseases, Jinan Military Region General Hospital of PLAJinanChina

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