Division of the Main Pulmonary Artery: Suboptimal Palliation for the Patient With a Univentricular Heart

We describe a patient in whom a thrombus formed in the distal main pulmonary artery stump after a bidirectional Glenn procedure with division of the main pulmonary artery and in whom a restrictive inlet ventricular septal defect also developed. These findings emphasize the importance of maintaining antegrade flow through the pulmonary trunk and providing dual sources of ventricular outflow with a Damus-Kaye-Stansel anastomosis in patients with a univentricular heart without pulmonary stenosis.