Ring-enforced right ventricle-to-pulmonary artery conduit in Norwood stage I reduces proximal conduit stenosis.

Schreiber, C; Kasnar-Samprec, J; Hörer, J; Eicken, A; Cleuziou, J; Prodan, Z; Lange, R

doi:10.1016/j.athoracsur.2009.07.081

2009

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Dokumenttyp:: Journal Article; Article
Autor(en):: Schreiber, C; Kasnar-Samprec, J; Hörer, J; Eicken, A; Cleuziou, J; Prodan, Z; Lange, R
Titel:: Ring-enforced right ventricle-to-pulmonary artery conduit in Norwood stage I reduces proximal conduit stenosis.
Abstract:: 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.
Zeitschriftentitel:: Ann Thorac Surg
Jahr:: 2009
Band / Volume:: 88
Heft / Issue:: 5
Seitenangaben Beitrag:: 1541-5
Sprache:: eng
Volltext / DOI:: doi:10.1016/j.athoracsur.2009.07.081
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/19853109
Print-ISSN:: 0003-4975
TUM Einrichtung:: Klinik für Herz- und Gefäßchirurgie (Prof. Lange); Klinik für Kinderkardiologie und angeborene Herzfehler (Prof. Hess)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Kinderkardiologie und angeborene Herzfehler (DHM) (Prof. Ewert)2009

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Gefäßchirurgie (DHM) (Prof. Krane)2009