title: Excellent midterm outcome of extracardiac conduit total cavopulmonary connection: results of 126 cases.
abstract: BACKGROUND
  Extracardiac conduit total cavopulmonary connection has shown good early results; however, its long-term outcome has yet to be reported.
  
  
  METHODS
  Of 282 patients who underwent extracardiac conduit total cavopulmonary connection since 1994, 126 patients who have been followed up for more than 5 years were included in this retrospective study. Actuarial survival rate, incidence of late complications, hemodynamic variables, and results of exercise tolerance test were reviewed.
  
  
  RESULTS
  Follow-up time was 96.4 +/- 23.0 months. There was 1 operative death and 6 late deaths. Actuarial survival rate was 95.2% and 93.6% at 5 and 10 years, respectively. Seven patients had late complications including new-onset supraventricular arrhythmia in 3, protein-losing enteropathy in 2, thromboembolism in 1, and bleeding complication in 1. Seven patients underwent reoperation not related to the conduit. Freedom from Fontan-related events was 88.8% at 5 years and 84.3% at 10 years. Late cardiac catheterization in 119 survivors showed central venous pressure of 9.9 +/- 2.9 mm Hg, cardiac index of 3.6 +/- 0.8 L x min(-1) x m(-2) and arterial oxygen saturation of 94.5 +/- 2.3%. No patient showed conduit stenosis. Plasma concentration of atrial and brain natriuretic peptide (pg/mL) were 28.9 +/- 20.0 and 25.8 +/- 44.5. Exercise test performed in 101 patients showed endurance time of 75.7 +/- 12.9% of normal value, peak heart rate of 92.3 +/- 14.4% of normal, and peak oxygen consumption of 90.0 +/- 20.0% of normal. The latest echocardiogram showed ejection fraction of 60.4 +/- 11.7%. Three patients had pacemaker rhythm, 1 had junctional rhythm, and 115 patients had sinus rhythm.
  
  
  CONCLUSIONS
  Midterm outcome of extracardiac conduit total cavopulmonary connection was satisfactory with low incidence of late mortality and morbidity, and excellent hemodynamic state.
authors.affiliation: Department of Cardiovascular Surgery, Fukuoka Children's Hospital, Fukuoka, Japan. nakano.t@fukuoka-child.jp
authors.forename: Toshihide
authors.initials: T
authors.lastname: Nakano
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kado
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tachibana
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hinokiyama
authors.forename: Akira
authors.initials: A
authors.lastname: Shiose
authors.forename: Masaki
authors.initials: M
authors.lastname: Kajimoto
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ando
mesh_terms: D009320:Atrial Natriuretic Factor / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005080:Exercise Test; D005112:Extracorporeal Circulation; D005500:Follow-Up Studies; D018729:Fontan Procedure / Q000009:adverse effects / Q000379:methods*; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006339:Heart Rate; D006801:Humans; D007223:Infant; D020097:Natriuretic Peptide, Brain / Q000097:blood; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor