Femoral Vein Homograft as Right Ventricle to Pulmonary Artery Conduit in Stage 1 Norwood Operation

T. K.Susheel Kumar, Mario Briceno-Medina, Shyam Sathanandam, Vijaya M. Joshi, Christopher J. Knott-Craig

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background The polytetrafluoroethylene tube used as right ventricle to pulmonary artery conduit in the stage 1 Norwood operation is associated with risks of suboptimal branch pulmonary artery growth, thrombosis, free insufficiency, and long-term right ventricular dysfunction. Our experience with use of valved femoral vein homograft as right ventricle to pulmonary artery conduit is described. Methods Between June 2012 and December 2015, 15 neonates with hypoplastic left heart syndrome or complex single ventricle underwent stage 1 Norwood operation with valved segment of femoral vein homograft as right ventricle to pulmonary artery conduit. The median age at surgery was 3 days and the mean weight was 3 kg. The size of the femoral vein homograft was 5 mm in 8 patients and 6 mm in 7 patients. Results There was no hospital or interstage mortality. Fourteen patients underwent Glenn operation, and 6 have undergone Fontan operation to date. The median Nakata index at pre-Glenn catheterization was 262 mm 2 /m 2 (interquartile range: 121 to 422 mm 2 /m 2 ). No patient had thrombosis of conduit. Most femoral vein conduits remained competent in the first month after stage 1 Norwood operation, although most became incompetent by 3 months. Catheter intervention on the conduit was necessary in 7 patients. Right ventricular function was preserved in most patients at follow-up. Conclusions The use of femoral vein homograft as right ventricle to pulmonary artery conduit in the Norwood operation is safe and associated with good pulmonary artery growth and preserved ventricular function. Balloon dilation of the conduit may be necessary during the interstage period.

Original languageEnglish (US)
Pages (from-to)1969-1974
Number of pages6
JournalAnnals of Thoracic Surgery
Volume103
Issue number6
DOIs
StatePublished - Jun 1 2017

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Norwood Procedures
Femoral Vein
Pulmonary Artery
Heart Ventricles
Allografts
Thrombosis
Hypoplastic Left Heart Syndrome
Right Ventricular Dysfunction
Fontan Procedure
Right Ventricular Function
Ventricular Function
Polytetrafluoroethylene
Growth
Catheterization
Dilatation
Catheters
Newborn Infant
Weights and Measures
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Femoral Vein Homograft as Right Ventricle to Pulmonary Artery Conduit in Stage 1 Norwood Operation. / Kumar, T. K.Susheel; Briceno-Medina, Mario; Sathanandam, Shyam; Joshi, Vijaya M.; Knott-Craig, Christopher J.

In: Annals of Thoracic Surgery, Vol. 103, No. 6, 01.06.2017, p. 1969-1974.

Research output: Contribution to journalArticle

Kumar, T. K.Susheel ; Briceno-Medina, Mario ; Sathanandam, Shyam ; Joshi, Vijaya M. ; Knott-Craig, Christopher J. / Femoral Vein Homograft as Right Ventricle to Pulmonary Artery Conduit in Stage 1 Norwood Operation. In: Annals of Thoracic Surgery. 2017 ; Vol. 103, No. 6. pp. 1969-1974.
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