title: High incidence of Dacron conduit stenosis for extracardiac Fontan procedure.
abstract: OBJECTIVE
  Extracardiac conduits are widely used to complete a Fontan circulation in patients with univentricular hearts. Although polytetrafluoroethylene conduits have proven good long-term patency, Dacron (polyethylene terephthalate) prostheses are still infrequently applied, with, as yet, no information on the long-term patency.
  
  
  METHODS
  All patients who received an extracardiac Dacron conduit (n = 12) were retrospectively studied. The initial conduit size was 16 mm in all recipients. The mean age at Fontan completion was 3.1 ± 0.7 years. Patients with clinical symptoms and/or significant conduit stenosis (>50% of diameter) underwent reoperation.
  
  
  RESULTS
  Of the 12 patients, 8 underwent reoperation (75%) at a mean interval of 6.5 ± 1.8 years after the Fontan operation. All conduits were replaced by an 18-mm polytetrafluoroethylene graft. The explants showed ubiquitous tissue deposits on the inner surface, with a residual internal diameter from 8 to 11 mm. All patients survived the extracardiac conduit replacement. Recovery was uneventful, except that 1 patient experienced long-lasting pleural fluid drainage. The mean hospital stay was 10.6 ± 12.0 days.
  
  
  CONCLUSIONS
  The incidence of extracardiac Dacron conduit stenosis in total cavopulmonary connection patients is high. These data indicate that the use of this type of conduit should be avoided. Vigilant follow-up is advised for those patients who have undergone Fontan completion with a Dacron extracardiac conduit.
authors.affiliation: Department of Pediatric Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Cardiothoracic Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: van Brakel
authors.affiliation: Department of Pediatric Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Schoof
authors.affiliation: Department of Pediatric Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: de Roo
authors.affiliation: Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Peter G J
authors.initials: PG
authors.lastname: Nikkels
authors.affiliation: Department of Pediatric Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Fabiola C M
authors.initials: FC
authors.lastname: Evens
authors.affiliation: Department of Pediatric Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: f.haas@umcutrecht.nl.
authors.forename: Felix
authors.initials: F
authors.lastname: Haas
mesh_terms: D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D002675:Child, Preschool; D003251:Constriction, Pathologic; D020878:Device Removal; D018729:Fontan Procedure / Q000009:adverse effects*; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D009426:Netherlands / Q000453:epidemiology; D011093:Polyethylene Terephthalates; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D011093:Polyethylene Terephthalates