title: Femoral Vein Homograft as Right Ventricle to Pulmonary Artery Conduit in Stage 1 Norwood Operation.
abstract: BACKGROUND
  The polytetrafluoroethylene tube used as right ventricle to pulmonary artery conduit in the stage 1 Norwood operation is associated with risks of suboptimal branch pulmonary artery growth, thrombosis, free insufficiency, and long-term right ventricular dysfunction. Our experience with use of valved femoral vein homograft as right ventricle to pulmonary artery conduit is described.
  
  
  METHODS
  Between June 2012 and December 2015, 15 neonates with hypoplastic left heart syndrome or complex single ventricle underwent stage 1 Norwood operation with valved segment of femoral vein homograft as right ventricle to pulmonary artery conduit. The median age at surgery was 3 days and the mean weight was 3 kg. The size of the femoral vein homograft was 5 mm in 8 patients and 6 mm in 7 patients.
  
  
  RESULTS
  There was no hospital or interstage mortality. Fourteen patients underwent Glenn operation, and 6 have undergone Fontan operation to date. The median Nakata index at pre-Glenn catheterization was 262 mm2/m2(interquartile range: 121 to 422 mm2/m2). No patient had thrombosis of conduit. Most femoral vein conduits remained competent in the first month after stage 1 Norwood operation, although most became incompetent by 3 months. Catheter intervention on the conduit was necessary in 7 patients. Right ventricular function was preserved in most patients at follow-up.
  
  
  CONCLUSIONS
  The use of femoral vein homograft as right ventricle to pulmonary artery conduit in the Norwood operation is safe and associated with good pulmonary artery growth and preserved ventricular function. Balloon dilation of the conduit may be necessary during the interstage period.
authors.affiliation: Department of Pediatric Cardiothoracic Surgery, Le Bonheur Children's Hospital and University of Tennessee Health Science Center, Memphis, Tennessee. Electronic address: tskumar@uthsc.edu.
authors.forename: T K Susheel
authors.initials: TKS
authors.lastname: Kumar
authors.affiliation: Department of Pediatric Cardiology, Le Bonheur Children's Hospital and University of Tennessee Health Science Center, Memphis, Tennessee.
authors.forename: Mario
authors.initials: M
authors.lastname: Briceno-Medina
authors.affiliation: Department of Pediatric Cardiology, Le Bonheur Children's Hospital and University of Tennessee Health Science Center, Memphis, Tennessee.
authors.forename: Shyam
authors.initials: S
authors.lastname: Sathanandam
authors.affiliation: Department of Pediatric Cardiology, Le Bonheur Children's Hospital and University of Tennessee Health Science Center, Memphis, Tennessee.
authors.forename: Vijaya M
authors.initials: VM
authors.lastname: Joshi
authors.affiliation: Department of Pediatric Cardiothoracic Surgery, Le Bonheur Children's Hospital and University of Tennessee Health Science Center, Memphis, Tennessee.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Knott-Craig
mesh_terms: D064591:Allografts; D000800:Angioplasty, Balloon; D005268:Femoral Vein / Q000637:transplantation*; D005865:Gestational Age; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000601:surgery*; D007231:Infant, Newborn; D058327:Norwood Procedures / Q000379:methods*; D011651:Pulmonary Artery / Q000601:surgery*