Total cavopulmonary connection with an extracardiac conduit: Experience with 100 patients

Shigehiko Tokunaga, Hideaki Kado, Yutaka Imoto, Munetaka Masuda, Yuichi Shiokawa, Kouji Fukae, Naoki Fusazaki, Shiro Ishikawa, Hisataka Yasui

研究成果: Contribution to journalArticle査読

55 被引用数 (Scopus)

抄録

Background. In the Fontan procedures total cavopulmonary connection with an extracardiac conduit is a concern. The potential benefits of an extracardiac conduit may be the avoidance of postoperative supraventricular arrhythmias over the long-term, hemodynamic benefits due to laminar flow, possibility of completion without anoxic arrest, and applicability to anomalous systemic or pulmonary venous return, or both anomalous systemic and pulmonary venous return. We demonstrate early to midterm results of total cavopulmonary connection with an extracardiac conduit. Methods. Between March 1994 and February 2000, a total of 100 patients underwent total cavopulmonary connection with an extracardiac conduit. In 27 patients, who underwent a single stage total cavopulmonary connection operation, 7 were done without palliation. Seventy-three patients had undergone a bidirectional Glenn shunt before completion of the total cavopulmonary connection. We used an expanded polytetrafluoroethylene tube graft as the extracardiac conduit. Results. Cardiopulmonary bypass time was 133.2 ± 55.2 minutes. Myocardial ischemic time was 38.5 ± 23.2 minutes in 40 patients who needed cardioplegic cardiac arrest for intracardiac procedures. Intraoperative fenestration was done in only 1 patient. There were no operative deaths. During follow-up of 37.3 months, there were 5 late deaths. When compared with the patients treated by the lateral tunnel technique in our institute, there was no significant difference in actuarial survival rate, but the event free rate of the extracardiac conduit group was significantly superior to the lateral tunnel group. Conclusions. Total cavopulmonary connection with the extracardiac conduit produced good results in short to midterm follow-up.

本文言語英語
ページ(範囲)76-80
ページ数5
ジャーナルAnnals of Thoracic Surgery
73
1
DOI
出版ステータス出版済み - 2002

All Science Journal Classification (ASJC) codes

  • 外科
  • 呼吸器内科
  • 循環器および心血管医学

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