Bidirectional cavopulmonary shunt using the azygos vein.

A case is described in which a two-year-old boy, diagnosed with common atrioventricular canal, pulmonary atresia, major aortopulmonary collateral artery, asplenia, and situs inversus, underwent palliative operations for the following: unifocalization of the right major aortopulmonary collateral artery, right ventricle-to-pulmonary artery shunt, and pulmonary artery plasty. Upon completion of the bidirectional cavopulmonary shunt operation, we addressed the stenotic lesions of the superior vena cava and left pulmonary artery, and a markedly expanded azygos vein. During this operation, the superior vena cava was divided and we performed cavopulmonary shunting with the azygos vein.