title: The somatic growth of autologous vessels in venous pathway after extracardiac total cavopulmonary connection.
abstract: OBJECTIVE
  In a total cavopulmonary connection (TCPC) with an extracardiac conduit, the future development of stenosis in the venous pathway and distortion of the pulmonary artery according to the somatic growth of the patients is a major concern for surgeons and pediatricians.
  
  
  METHODS
  Thirty patients who underwent extracardiac TCPC (EC-TCPC) between 1990 and 1998 and who had received at least two postoperative angiograms were enrolled in this study. To evaluate the postoperative change in the anastomosis, the cross-sectional area of the venous root at three different points was measured on the first and second angiograms after the EC-TCPC. Further, to evaluate the somatic growth of the autologous tissue, 12 patients who grew more than 10 cm in height after the completion of the EC-TCPC were selected among the 30 patients. We measured the length of three different parts, the diameter of the pulmonary artery, length of the artificial graft, and length between the branching point of the hepatic vein and artificial graft's anastomotic site to the inferior vena cava.
  
  
  RESULTS
  The cross-sectional area at each point did not change during the follow-up, and the pressure gradient across the grafts has not been observed. The diameter of the pulmonary artery and length of the inferior vena cava above the hepatic vein insertion grew similarly during the follow-up.
  
  
  CONCLUSIONS
  The mid-term clinical results after the completion of the EC-TCPC, including the somatic growth of the venous pathway, were satisfactory.
authors.affiliation: Department of Cardiovascular Surgery, Fukuoka Children's Hospital, Fukuoka, Japan. iwaki@nms.ac.jp
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Iwaki
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Shiokawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imoto
authors.forename: Toshihide
authors.initials: T
authors.lastname: Nakano
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Sonoda
authors.forename: Akira
authors.initials: A
authors.lastname: Shiose
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kado
mesh_terms: D000293:Adolescent; D000714:Anastomosis, Surgical; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology* / Q000601:surgery; D005260:Female; D006330:Heart Defects, Congenital / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D011184:Postoperative Period; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000473:pathology* / Q000601:surgery; D012039:Regional Blood Flow; D013997:Time Factors; D014682:Vena Cava, Inferior / Q000473:pathology* / Q000601:surgery