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Open anastomosis of extracardiac conduit for total cavopulmonary connection decreases post-operative pleural effusion

Published online by Cambridge University Press:  02 September 2010

Ryo Aeba ,
Masanori Morita ,
Toru Matayoshi  and
Ryohei Yozu
Ryo Aeba*
Affiliation:
Division of Cardiovascular Surgery, Department of Surgery, Keio University, Tokyo, Japan
Masanori Morita
Affiliation:
Department of Bioengineering, Keio University, Tokyo, Japan
Toru Matayoshi
Affiliation:
Department of Bioengineering, Keio University, Tokyo, Japan
Ryohei Yozu
Affiliation:
Division of Cardiovascular Surgery, Department of Surgery, Keio University, Tokyo, Japan
*
Correspondence to: R. Aeba, MD, Department of Surgery, Division of Cardiovascular Surgery, Keio University, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan. Tel: +81 3 3353 1211 Ext. 62331; Fax: +81 3 5379 3034; E-mail: aebajp@gmail.com
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Abstract

Objective

The goal of this study was to see whether the open anastomosis technique using vacuum-assisted venous drainage at the time of the Fontan procedure was associated with decreased post-operative pleural effusion.

Methods

We analysed a subgroup of patients with a functional single ventricle who underwent non-fenestrated total cavopulmonary connection completion with the insertion of an extracardiac conduit as the sole or predominant procedure conducted by a single surgeon at a single institute, using either an open or closed anastomosis technique.

Results

Median age and weight were 2.3 years, with a range from 1.3 to 27.6 years and 11.4 kilograms, with a range from 9.7 to 43 kilograms, respectively. The open anastomosis technique was associated with a shorter bypass run (p = 0.015), decreased surgical duration (p = 0.032), fewer pleural effusion days (p = 0.049), and lesser pleural effusion (p = 0.013) than closed anastomosis. Correlation analysis demonstrated a significant relationship between the amount of pleural effusion and surgical duration (correlation efficient, 0.535; p = 0.033). A logistic regression model showed that the open technique was associated with a 20-fold increase in the likelihood of having a total chest tube discharge of less than 300 millilitres (p = 0.027).

Conclusions

The open anastomosis technique shortens operative duration and bypass run, which in turn might contribute to decreased pleural effusion soon after the modified Fontan procedure.

Keywords

Congenital cardiac diseaseFontancardiopulmonary bypassinflammatory response
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 6 , December 2010 , pp. 686 - 691
Copyright
Copyright © Cambridge University Press 2010

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