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): Iki Adachi Toshikatsu Yagihara Ikuo Hagino Toru Ishizaka Masahiro Koh Hideki Uemura Soichiro Kitamura Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Adachi, I. Articles by Kitamura, S. Search for Related Content PubMed PubMed Citation Articles by Adachi, I. Articles by Kitamura, S. Related Collections Congenital - cyanotic Pericardium

J Thorac Cardiovasc Surg 2005;130:1517-1522
© 2005 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

Fontan operation with a viable and growing conduit using pedicled autologous pericardial roll: Serial changes in conduit geometry

^a Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan
^b Department of Cardio-Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom

Received for publication April 9, 2005; revisions received April 9, 2005; accepted for publication April 9, 2005.

^_* Address for reprints: Toshikatsu Yagihara, MD, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan (Email: yagihara{at}hsp.ncvc.go.jp).

OBJECTIVE: We sought to examine midterm results of the Fontan operation with an extracardiac conduit using pedicled autologous pericardial roll, with special attention to angiographic evaluation of serial changes in conduit geometry.

METHODS: Of 202 patients subjected to the Fontan operation since 1996, the conduit was used in 28 patients who had intact pericardium. We retrospectively reviewed a consecutive series of these patients, and serial changes in conduit geometry were accessed in 16 patients who underwent catheter examinations twice at 1.1 ± 0.4 and 4.5 ± 1.4 years postoperatively.

RESULTS: There was one early and one late death. Except for a patient with apicocaval juxtaposition in whom a conduit occlusion developed caused by compression between the vertebral bodies and the ventricle, there were no important complications. Angiographically, conduit volume, estimated by using the MULTI-SLICE method, increased significantly (3490 ± 2166 to 5426 ± 3081 mm³, P < .001), whereas the volume per body weight remained unchanged. Conduit diameter increased significantly at both the inferior vena caval end (16.8 ± 4.8 to 19.8 ± 4.8 mm, P < .001) and the pulmonary artery end (11.9 ± 3.8 to 14.2 ± 4.2 mm, P < .001), whereas the diameter indexed to the normal right pulmonary artery remained unchanged. The cross-sectional area of the conduit increased in parallel with that of the normal right pulmonary artery. The ratio of the widest to the narrowest diameter of the conduit exhibited no significant change.

CONCLUSIONS: Midterm results of the Fontan operation with pedicled autologous pericardial roll were favorable. Proportional increase of conduit size was demonstrated, with its shape preserved. This suggested a potential of the conduit to grow and that growth correlated with somatic development.

This article has been cited by other articles:

				Y. Ochiai, Y. Imoto, M. Sakamoto, T. Kajiwara, A. Sese, M. Watanabe, T. Ohno, and K. Joo Mid-term follow-up of the status of Gore-Tex graft after extracardiac conduit Fontan procedure Eur. J. Cardiothorac. Surg., July 1, 2009; 36(1): 63 - 68. [Abstract] [Full Text] [PDF]

				W. A. Goetz, T. E. Tan, K. H. Lim, F. Xiong, S. L. H. Salgues, N. Grousson, Y. L. Chua, and J. H. Yeo Autologous pericardial pulmonary conduit with single point attached commissures in a sheep model Eur. J. Cardiothorac. Surg., January 1, 2008; 33(1): 48 - 52. [Abstract] [Full Text] [PDF]

				I. Adachi, T. Yagihara, K. Kagisaki, I. Hagino, T. Ishizaka, J. Kobayashi, S. Kitamura, and H. Uemura Preoperative small pulmonary artery did not affect the midterm results of Fontan operation Eur. J. Cardiothorac. Surg., July 1, 2007; 32(1): 156 - 162. [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]

				I. Adachi, H. Ishibashi-Ueda, T. Yagihara, K. Kagisaki, I. Hagino, T. Ishizaka, and H. Uemura Immunohistologic examination of pedicled autologous pericardium 9 years after implantation for an extracardiac conduit in Fontan pathway: Comparison with in situ pericardium and pulmonary arterial tissue from the same patient J. Thorac. Cardiovasc. Surg., April 1, 2007; 133(4): 1101 - 1103. [Full Text] [PDF]

				A. Nakahira, T. Yagihara, K. Kagisaki, I. Hagino, T. Ishizaka, M. Koh, H. Uemura, and S. Kitamura Partial anomalous pulmonary venous connection to the superior vena cava. Ann. Thorac. Surg., September 1, 2006; 82(3): 978 - 982. [Abstract] [Full Text] [PDF]

				I. Adachi, T. Yagihara, H. Ishibashi-Ueda, and S. Kitamura Immunohistological findings for an extracardiac conduit in Fontan pathway constructed with pedicled autologous pericardium. Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 1059 - 1060. [Abstract] [Full Text] [PDF]