Midterm follow-up of the status of Gore-Tex graft after extracardiac conduit Fontan procedure.
نویسندگان
چکیده
OBJECTIVE Extracardiac conduit Fontan procedure has some theoretical advantages over other types of Fontan procedures, such as optimized flow dynamics, a lower frequency of arrhythmias, and technical ease of procedure. However, lack of growth potential and thrombogenicity of the artificial conduit is the main concern and can possibly lead to reoperation for the conduit stenosis. In this study, we investigated the change and the status of the Gore-Tex graft used in extracardiac conduit Fontan procedure. METHODS Between 1996 and 2005, 154 patients underwent extracardiac conduit Fontan procedure using Gore-Tex graft. Among these, 46 patients underwent cardiac catheterization during follow-up period. We measured the internal diameter of the conduit and inferior vena cava angiographically. RESULTS Mean follow-up duration was 36.1+/-19.7 months. The conduit diameter used was 16 mm in 10 patients, 18 mm in 16, 20 mm in 14, 22 mm in 4, and 24 mm in 2 patients. The mean conduit-to-inferior vena cava cross-sectional area ratio was 1.25+/-0.33. According to the conduit size used, this ratio was 1.03+/-0.17 for 16 mm conduits, 1.33+/-0.37 for 18 mm, 1.33+/-0.36 for 20 mm, 1.28+/-0.26 for 22 mm, and 1.05+/-0.06 for 24 mm conduits (p<0.05, 16 mm vs 18 mm and 20 mm). The mean percent decrease of the conduit cross-sectional area was 14.3+/-8.5%, and this did not differ significantly according to the conduit size (p=0.82). Follow-up duration and the percent decrease of the conduit cross-sectional area did not show significant correlation (r=0.22, p=0.14). There was no reoperation due to conduit stenosis. CONCLUSIONS During midterm follow-up of about 3 years, the conduit cross-sectional area decreased by 14%, and this did not differ according to the conduit size used. The extent of decrease of the conduit cross-sectional area remained stable irrespective of the follow-up duration. Sixteen millimeters conduit showed no evidence of clinically significant stenosis, but careful follow-up is warranted because of the possible conduit stenosis relative to the patients' somatic growth.
منابع مشابه
Mid-term follow-up of the status of Gore-Tex graft after extracardiac conduit Fontan procedure.
OBJECTIVE Extracardiac conduit Fontan procedure (ECFP) using Gore-Tex graft has been performed with increasing frequency for the patients with functional single ventricle. However, lack of growth potential and longevity of the conduit are consistent concerns and main points of criticism of the ECFP. In this study, we investigated the mid-term status of the Gore-Tex graft used in the ECFP by com...
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Background & Aims: This study was done in hem dialysis patients who referred to Imam Khomeini hospital of Urmia for insertion of arterial -venous fistula with Gore-tex, in whom there was not possibility of natural fistula. Objectives were assessment and comparison of complications and patency of arterial-venous fistulas was done with 6 and 8 mm Gore-tex graft in the upper limb and comparison of...
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Results Two patients underwent the first Fontan palliations while participating in a development program for congenital heart surgery. Both presented at 32-33 months of age with baseline oxygen saturations of 82-84%. Patient 1 underwent an extracardiac Fontan with a GoreTex conduit larger than the IVC due to limited supplies. Postoperatively, the patient decompensated to a low cardiac output st...
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A 34 months-old male patient with double inlet right ventricle with nonconfluent pulmonary arteries who underwent successful extracardiac fenestarated Fontan procedure using pre-designed T-shaped PTFE vascular graft after multi-step rehabilitation of the diminutive hilar pulmonary arteries. At first we performed 6 mm confluent pulmonary artery vascular graft implantation with 4 mm BT shunt at p...
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The extracardiac conduit Fontan procedure is the last surgical step in the treatment of patients with a functional single ventricle. An acquired pulmonary arteriovenous malformation may appear perioperatively or postoperatively due to an uneven hepatic flow distribution. Here we report a case of a bifurcated Y-graft Fontan operation in a 15-year-old male patient with a unilateral pulmonary arte...
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عنوان ژورنال:
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
دوره 31 6 شماره
صفحات -
تاریخ انتشار 2007