title: Total cavopulmonary connection with an extracardiac conduit: experience with 100 patients.
abstract: 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.
authors.affiliation: Department of Cardiovascular Surgery, Fukuoka Children's Hospital, Japan. f-kodomo@aurora.dti.ne.jp
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Tokunaga
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kado
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imoto
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Shiokawa
authors.forename: Kouji
authors.initials: K
authors.lastname: Fukae
authors.forename: Naoki
authors.initials: N
authors.lastname: Fusazaki
authors.forename: Shiro
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Hisataka
authors.initials: H
authors.lastname: Yasui
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005112:Extracorporeal Circulation; D018729:Fontan Procedure / Q000379:methods* / Q000401:mortality; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006801:Humans; D018633:Pulmonary Atresia / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis; D018785:Tricuspid Atresia / Q000401:mortality / Q000601:surgery