The effect of the conduit size on middle-term outcomes in patients with extracardiac total cavopulmonary connection

Keiichi Hirose*, Akio Ikai, Hiroki Ito, Motonari Ishidou, Daisuke Toritsuka, Yuji Nakamura, Seito Watanabe, Eiji Nakatani, Kisaburo Sakamoto

*この論文の責任著者

研究成果: ジャーナルへの寄稿学術論文査読

抄録

OBJECTIVES: The 18- and 16-mm conduits in extracardiac total cavopulmonary connection (eTCPC) were reported to be optimal based on energy loss and flow stagnation at the relatively early phase. However, because the artificial conduit lacks growth potential, we have recently encountered some cases in which the conduit needs to be changed several years after eTCPC. These cases prompted us to reconsider the surgical strategy for eTCPC. METHODS: We reviewed our 20-year single-centre experience with eTCPC patients (n ¼ 256) to compare the 18-mm conduit (n ¼ 195) and 16-mm conduit (n ¼ 61) in terms of mortality and morbidity. RESULTS: The 16-mm conduit was used significantly more frequently in patients whose main chamber was right ventricle (P < 0.001). There was also a significant difference in preoperative inferior vena cava pressure (P ¼ 0.008). There was a significant difference in the actuarial rate of freedom from late-occurring complications, including mortality, between the 2 groups (P ¼ 0.003). There was a significant difference in the actuarial rate of reoperation-free survival (P ¼ 0.042); however, there was no significant difference in resurgical intervention for the conduit (P ¼ 0.333). In multivariate analysis, preoperative inferior vena cava pressure was an independent predictor for late-occurring complications (hazard ratio 1.19; P ¼ 0.026). Conduit size (18 or 16 mm) itself was not an independent predictive factor for late-occurring complications (P ¼ 0.690). CONCLUSIONS: The mid-term clinical outcomes in patients who underwent eTCPC were excellent with low mortality. Preoperative inferior vena cava pressure was the only predictive risk factor for postoperative morbidity, and the 16 mm conduit was not predictive thereof.

本文言語英語
論文番号ivae013
ジャーナルInterdisciplinary cardiovascular and thoracic surgery
38
2
DOI
出版ステータス出版済み - 2024/02/01

ASJC Scopus 主題領域

  • 循環器および心血管医学
  • 呼吸器内科
  • 外科

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