Growth potential of U-clip interrupted versus polypropylene running suture anastomosis in congenital cardiac surgery: intermediate term results.
Although U-clip anastomoses were studied for hemodynamics and patency, their potential for unimpeded growth after congenital cardiovascular surgery has not been investigated yet. In 53 children aged 2.1+/-3.3 years operated on between March 1998 and August 2005 growth of U-clip (U) vs. polypropylene running sutured (P) anastomoses in coarctation repair (Coarc; n=26), bi-directional Glenn (BDG; n=13) and arterial switch operation (ASO; n=14) was retrospectively analysed. Coarc showed 2.39+/-4.33 vs. 3.09+/-2.24 mm of growth during the observation period (21+/-16 vs. 30+/-27 months); no growth (0 vs.16%), restenosis (14 vs. 37%) and reinterventions (14 vs. 11%) were similar (all in U vs. P, P=ns). BDG showed 3.68+/-3.43 vs. 2.50+/-2.55 mm (P=ns) of growth during 15+/-5 vs. 29+/-18 months (P=0.046); no growth (17 vs. 0%), stenosis (0 vs. 14%) and reinterventions (0%) were similar in U vs. P, respectively (P=ns). Main pulmonary artery (MPA) anastomosis in ASO showed 0.28+/-1.73 vs. 1.30+/-3.16 mm of growth during 8+/-14 vs. 28+/-28 months; no growth (60 vs. 14%), stenosis (50 vs. 63%) and reinterventions (0%) were similar (all in U vs. P, P=ns). Anastomotic growth, stenosis and reintervention rates show no difference between interrupted U-clip and polypropylene running sutured technique in Coarc repair, BDG and MPA anastomosis in ASO.
Berdat
Pascal A
PA
Clinic for Cardiovascular Surgery, Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland. pascal.berdat@hirslanden.ch
Lavanchy
Joel L
JL
Schönhoff
Florian
F
Pavlovic
Mladen
M
Pfammatter
Jean-Pierre
JP
Carrel
Thierry P
TP
D000293:Adolescent; D000714:Anastomosis, Surgical; D001011:Aorta / Q000254:growth & development / Q000601:surgery; D001017:Aortic Coarctation / Q000503:physiopathology / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011126:Polypropylenes; D011651:Pulmonary Artery / Q000254:growth & development / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D013525:Surgical Instruments; D013536:Suture Techniques / Q000009:adverse effects / Q000295:instrumentation*; D013537:Sutures; D013997:Time Factors; D016896:Treatment Outcome
D011126:Polypropylenes