Extracardiac total cavopulmonary connection via an atrial and pericardial tunnel.

: We performed extracardiac total cavopulmonary connection using only native tissue in two patients with complex heart disease. The extracardiac lateral tunnel was constructed from pedicled autologous pericardium and atrial wall During follow-up both patients remained in the New York Heart Association functional class I and demonstrated normal sinus rhythm. These modifications not only avoid the risk of potential postoperative complications due to artificial materials, but also allow growth of the conduit.