HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Yukihisa Isomatsu Narutoshi Hibino Masayoshi Nagatsu Hiromi Kurosawa Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Isomatsu, Y. Articles by Kurosawa, H. Search for Related Content PubMed PubMed Citation Articles by Isomatsu, Y. Articles by Kurosawa, H. Related Collections Congenital - cyanotic

J Thorac Cardiovasc Surg 2003;126:1958-1962
© 2003 The American Association for Thoracic Surgery

Evolving technology

Extracardiac total cavopulmonary connection using a tissue-engineered graft

^a Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan

Received for publication March 10, 2003; revisions received May 5, 2003; accepted for publication June 6, 2003.

^* Address for reprints: Yukihisa Isomatsu, MD, First Department of Surgery, Yokohama City University School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan 236-0004, Japan
isomatsu{at}med.yokohama-cu.ac.jp

OBJECTIVE: Extracardiac and lateral tunnel total cavopulmonary connection are currently 2 major options for patients with a single ventricle physiology. However, each procedure has some disadvantages over the other. We developed a new technique of extracardiac total cavopulmonary connection using a tissue-engineered graft to overcome some of the disadvantages previously associated with both the extracardiac and lateral tunnel procedures.

METHODS: Between February 2001 and October 2002, 8 patients underwent an extracardiac total cavopulmonary connection using a tissue-engineered graft in our institution. Collected bone marrow cells (1 x 10⁸ mononucleocytes) from a patient (1-4 mL/kg body weight) were seeded onto a biodegradable scaffold composed of polycaprolactone-polylactic acid copolymer reinforced with woven polylactic acid. After a 2- to 4-hour cultivation, the seeded scaffold was implanted as an extracardiac conduit during the total cavopulmonary connection operation.

RESULTS: There were no hospital or late deaths. At a mean follow-up of 13.4 months (range 4-25 months), all patients are alive and asymptomatic with no need for repeat surgery. A postoperative catheter examination or computed tomography showed all tissue-engineered grafts to be patent and revealed no stenosis, obstruction, or aneurysmal change in the 8 patients.

CONCLUSION: We believe that extracardiac total cavopulmonary connection using a tissue-engineered graft has the potential to overcome some of the disadvantages previously associated with extracardiac or lateral tunnel total cavopulmonary connection. However, an extended follow-up period is required to clarify the long-term clinical outcome for the tissue-engineered graft.

This article has been cited by other articles:

				K. Hayashida, K. Kanda, H. Yaku, J. Ando, and Y. Nakayama Development of an in vivo tissue-engineered, autologous heart valve (the biovalve): Preparation of a prototype model J. Thorac. Cardiovasc. Surg., July 1, 2007; 134(1): 152 - 159. [Abstract] [Full Text] [PDF]

				C. Lee, C.-H. Lee, S. W. Hwang, H. G. Lim, S.-J. Kim, J. Y. Lee, W.-S. Shim, and W.-H. Kim Midterm follow-up of the status of Gore-Tex graft after extracardiac conduit Fontan procedure Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1008 - 1012. [Abstract] [Full Text] [PDF]

				S. Iwasa, T. Shin'oka, T. Sakamoto, Y. Nagase, H. Hasegawa, and H. Kurosawa Successful extracardiac total cavo pulmonary connection (TCPC) after external tracheobronchial stenting for tracheobronchomalacia Interactive CardioVascular and Thoracic Surgery, October 1, 2006; 5(5): 599 - 601. [Abstract] [Full Text] [PDF]

				H. Gulbins, A. Pritisanac, K. Pieper, A. Goldemund, B. M. Meiser, B. Reichart, and S. Daebritz Successful Endothelialization of Porcine Glutaraldehyde-Fixed Aortic Valves in a Heterotopic Sheep Model Ann. Thorac. Surg., April 1, 2006; 81(4): 1472 - 1479. [Abstract] [Full Text] [PDF]

				T. Miura, Y. Isomatsu, T. Shin'oka, and H. Kurosawa Conversion to total cavopulmonary connection 9 years after closure of a large ventricular septal defect Interactive CardioVascular and Thoracic Surgery, March 1, 2004; 3(1): 129 - 131. [Abstract] [Full Text] [PDF]