The somatic growth of autologous vessels in venous pathway after extracardiac total cavopulmonary connection.
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.
Iwaki
Hideyuki
H
Department of Cardiovascular Surgery, Fukuoka Children's Hospital, Fukuoka, Japan. iwaki@nms.ac.jp
Masuda
Munetaka
M
Shiokawa
Yuichi
Y
Imoto
Yutaka
Y
Nakano
Toshihide
T
Sonoda
Hiromichi
H
Shiose
Akira
A
Kado
Hideaki
H
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