Seven-Year Clinical Experience With the Extracardiac Pedicled Pericardial Fontan Operation

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.

Section: Discussionmentioning

confidence: 99%

“…To overcome the problems of artificial conduits, pedicled autologous pericardium or tissue-engineered graft as an extracardiac conduit are being used at some centers, and the longterm results are worth waiting for [13][14][15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

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

Lee

Hwang

Lim

et al. 2007

“…An effort has to be made to place sutures on the pericardium in a careful fashion and to avoid any fullthickness sutures near the phrenic nerve. With these cautions, there was no postoperative phrenic nerve palsy, either in a series of 54 patients of Kavarna and associates [20], or in our cohort.…”

Section: Discussionmentioning

confidence: 77%

“…The age at Fontan operation was 2.8 AE 1.5 (1.2-6.9) years and 20 patients were younger than 2 years. The mean body weight was 12.3 AE 3.2 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) kg.…”

Section: Methodsmentioning

confidence: 99%

Results of an extracardiac pericardial-flap lateral tunnel Fontan operation☆

Park

Youn

Yang

et al. 2008

Extracardiac pericardial-flap lateral tunnel Fontan operation is relatively simple and feasible even in patients with previous median sternotomies. The mid-term results were acceptable, and the lateral tunnel demonstrated a tendency to preserve its tubular shape. However in some patients, dilatation of the pericardial-flap tunnel was observed during follow up. Longer follow-up is required to determine the morphologic changes of the lateral tunnel and the value of this technique.

“…Autologous pericardium is widely accepted for use as a material for various reconstructive procedures in congenital cardiovascular surgery, and has been used in pedicled fashion with the expectation that it will be able to grow and remain viable after implantation [1][2][3][4][5]. However, no clinical study has evaluated the histological characteristics of implanted pedicled pericardium long after previous implantation, although some experimental animal studies have clearly demonstrated preservation of viability and growth ability of pedicled pericardium [6,7].…”

Section: Introductionmentioning

confidence: 99%

Immunohistological findings for an extracardiac conduit in Fontan pathway constructed with pedicled autologous pericardium

Adachi¹,

Yagihara²,

Ishibashi‐Ueda³

et al. 2006

Although autologous pericardium has been used in pedicled fashion for various reconstructive procedures in congenital cardiovascular surgery with the expectation that it will be able to grow and remain viable after implantation, no clinical study has evaluated the histological characteristics of implanted pedicled pericardium long after previous implantation. We describe herein histological findings of pedicled pericardium, which had been used for three years as an extracardiac conduit in Fontan pathway. A four-year-old boy with a history of Fontan operation using pedicled autologous pericardial roll required conduit replacement three years after the previous operation, and resected pericardial tissue was examined immunohistologically. Staining for CD34 revealed abundant microvasculature, suggesting preservation of viability. Staining for factor VIII demonstrated the presence of endothelium on the luminal surface of the conduit. Elastica-van Gieson staining revealed a band of elastic tissue, which is generally found not in the native pericardium but in the vascular wall structures. These findings suggested that the pedicled pericardium thus appeared to have remained viable and might have differentiated to resemble tissue of the vascular wall after having been used in Fontan pathway.