TY - JOUR
T1 - Ring-Enforced Right Ventricle-to-Pulmonary Artery Conduit in Norwood Stage I Reduces Proximal Conduit Stenosis
AU - Schreiber, Christian
AU - Kasnar-Samprec, Jelena
AU - Hörer, Jürgen
AU - Eicken, Andreas
AU - Cleuziou, Julie
AU - Prodan, Zsolt
AU - Lange, Rüdiger
PY - 2009/11
Y1 - 2009/11
N2 - Background: An increasing number of surgeons prefer to place a conduit from the right ventricle to the pulmonary artery at the time of the Norwood stage I procedure. Proximal conduit stenoses have led us to modify this technique by using ring-enforced polytetrafluoroethylene conduits. Methods: Angiograms of 24 patients with conventional conduits (CC) and 28 patients with ring-enforced conduits (RC) before partial bidirectional cavopulmonary anastomosis were analyzed. The degree of conduit stenosis on three different levels-proximal anastomosis, substernal part of the conduit, and distal anastomosis-was compared between the two groups. Results: In the RC group, the extent of conduit stenosis at the level of proximal anastomosis and within the substernal proximal third of the conduit was minimized (23% ± 22% vs 45% ± 22%, p = 0.001, and 7% ± 6% vs 49% ± 26%, p < 0.001, respectively). At the level of the anastomosis with the pulmonary arteries, results were similar in the RC group (24% ± 14%) vs CC group (31% ± 15%, p = 0.103). Significantly fewer patients in the RS group required urgent intervention (dilatation ± stenting) or early stage II operation (1 vs 6 patients, p = 0.034). Conclusions: The use of a ring-enforced polytetrafluoroethylene conduit between the right ventricle and the pulmonary artery in Norwood stage I palliation effectively prevents substernal compression and reduces interstage morbidity.
AB - Background: An increasing number of surgeons prefer to place a conduit from the right ventricle to the pulmonary artery at the time of the Norwood stage I procedure. Proximal conduit stenoses have led us to modify this technique by using ring-enforced polytetrafluoroethylene conduits. Methods: Angiograms of 24 patients with conventional conduits (CC) and 28 patients with ring-enforced conduits (RC) before partial bidirectional cavopulmonary anastomosis were analyzed. The degree of conduit stenosis on three different levels-proximal anastomosis, substernal part of the conduit, and distal anastomosis-was compared between the two groups. Results: In the RC group, the extent of conduit stenosis at the level of proximal anastomosis and within the substernal proximal third of the conduit was minimized (23% ± 22% vs 45% ± 22%, p = 0.001, and 7% ± 6% vs 49% ± 26%, p < 0.001, respectively). At the level of the anastomosis with the pulmonary arteries, results were similar in the RC group (24% ± 14%) vs CC group (31% ± 15%, p = 0.103). Significantly fewer patients in the RS group required urgent intervention (dilatation ± stenting) or early stage II operation (1 vs 6 patients, p = 0.034). Conclusions: The use of a ring-enforced polytetrafluoroethylene conduit between the right ventricle and the pulmonary artery in Norwood stage I palliation effectively prevents substernal compression and reduces interstage morbidity.
UR - http://www.scopus.com/inward/record.url?scp=70449715606&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2009.07.081
DO - 10.1016/j.athoracsur.2009.07.081
M3 - Article
C2 - 19853109
AN - SCOPUS:70449715606
SN - 0003-4975
VL - 88
SP - 1541
EP - 1545
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 5
ER -