Superior cavopulmonary connection
This procedure has been undertaken as a prelude to creation of the Fontan circulation in both subsets. Because of the presence of bilateral sinus nodes in right isomerism, and the unusual location of sinus node in left isomerism, the superior caval vein should be transected at the level of the right pulmonary artery, retaining a small length of superior caval wall. Dissection along the atrial roof should be undertaken with great care to avoid potential injury to the sinus nodal artery.37,41