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