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Orthotopic heart transplantation was performed successfully in a 7-year-old girl with visceroatrial situs inversus. Creation of two autologous left-sided atrial tissue baffles tunneled the left superior vena cava and inferior vena cava to the right of the pulmonary veins. The reconstructed caval tunnels remain widely patent more than 4 years after transplantation. The ability of autologous tissue to grow with the patient has distinct advantages in the pediatric transplant population.
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