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Eur J Cardiothorac Surg 2007;31:1008-1012. doi:10.1016/j.ejcts.2007.03.013
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Midterm follow-up of the status of Gore-Tex graft after extracardiac conduit Fontan procedure

^a Department of Thoracic and Cardiovascular Surgery, Sejong Heart Institute, Sejong General Hospital, Bucheon, South Korea
^b Pediatric Cardiology, Sejong Heart Institute, Sejong General Hospital, Bucheon, South Korea
^c Department of Thoracic and Cardiovascular Surgery, Clinical Research Institute, Seoul National University, College of Medicine, Seoul National University Children's Hospital, Seoul, South Korea

Received 13 November 2006; received in revised form 6 March 2007; accepted 9 March 2007.

^_* Corresponding author. Address: Department of Thoracic and Cardiovascular Surgery, Sejong Heart Institute, Sejong General Hospital, 91-121 Sosa Bon 2-dong, Sosa-ku, Bucheon-shi, Kyungki-do 422-232, South Korea. Tel.: +82 32 340 1151; fax: +82 32 340 1236. (Email: leechha{at}sejongh.co.kr).

Objective: Extracardiac conduit Fontan procedure has some theoretical advantages over other types of Fontan procedures, such as optimized flow dynamics, a lower frequency of arrhythmias, and technical ease of procedure. However, lack of growth potential and thrombogenicity of the artificial conduit is the main concern and can possibly lead to reoperation for the conduit stenosis. In this study, we investigated the change and the status of the Gore-Tex graft used in extracardiac conduit Fontan procedure. Methods: Between 1996 and 2005, 154 patients underwent extracardiac conduit Fontan procedure using Gore-Tex graft. Among these, 46 patients underwent cardiac catheterization during follow-up period. We measured the internal diameter of the conduit and inferior vena cava angiographically. Results: Mean follow-up duration was 36.1 ± 19.7 months. The conduit diameter used was 16 mm in 10 patients, 18 mm in 16, 20 mm in 14, 22 mm in 4, and 24 mm in 2 patients. The mean conduit-to-inferior vena cava cross-sectional area ratio was 1.25 ± 0.33. According to the conduit size used, this ratio was 1.03 ± 0.17 for 16 mm conduits, 1.33 ± 0.37 for 18 mm, 1.33 ± 0.36 for 20 mm, 1.28 ± 0.26 for 22 mm, and 1.05 ± 0.06 for 24 mm conduits (p < 0.05, 16 mm vs 18 mm and 20 mm). The mean percent decrease of the conduit cross-sectional area was 14.3 ± 8.5%, and this did not differ significantly according to the conduit size (p = 0.82). Follow-up duration and the percent decrease of the conduit cross-sectional area did not show significant correlation (r = 0.22, p = 0.14). There was no reoperation due to conduit stenosis. Conclusions: During midterm follow-up of about 3 years, the conduit cross-sectional area decreased by 14%, and this did not differ according to the conduit size used. The extent of decrease of the conduit cross-sectional area remained stable irrespective of the follow-up duration. Sixteen millimeters conduit showed no evidence of clinically significant stenosis, but careful follow-up is warranted because of the possible conduit stenosis relative to the patients’ somatic growth.

Key Words: Single ventricle • Fontan procedure • Extracardiac conduit

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				Y. Ochiai, Y. Imoto, M. Sakamoto, T. Kajiwara, A. Sese, M. Watanabe, T. Ohno, and K. Joo Mid-term follow-up of the status of Gore-Tex graft after extracardiac conduit Fontan procedure Eur. J. Cardiothorac. Surg., July 1, 2009; 36(1): 63 - 68. [Abstract] [Full Text] [PDF]

				S.-J. Kim, W.-H. Kim, H.-G. Lim, and J.-Y. Lee Outcome of 200 patients after an extracardiac Fontan procedure J. Thorac. Cardiovasc. Surg., July 1, 2008; 136(1): 108 - 116. [Abstract] [Full Text] [PDF]