An adequate atrial septal defect is ensured at this time by looking through the incised cavo-atrial junction. If necessary, more septum primum is excised, with or without cutting back on the coronary sinus towards the left atrium. The anterior row of the anastomosis is completed by augmenting the roof of the anastomosis with a triangular patch of homograft, GoreTex, or pericardium. The atriotomy is closed with running Prolene suture. With suction being applied both to the aortic root, and while the coronary arteries are being temporarily occluded, the aortic cross-clamp is removed.
Ventilation is resumed.
Pleural tubes and pacing leads are placed and secured. Following full rewarming, the patient is weaned from cardiopulmonary bypass. The inferior vena cava cannula is removed. The heparin is reversed with protamine. Diagnostic pressures of the aortic root and the superior vena cava are performed.