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A new surgical approach for preparation of candidates for the Fontan operation with acquired systemic-pulmonary collateral arteries

Published online by Cambridge University Press:  19 August 2008

Osamu Matsuki*
Affiliation:
From the Department of Cardiovascular Surgery, National Cardiovascular Center, Suita
Toshikatsu Yagihara
Affiliation:
From the Department of Cardiovascular Surgery, National Cardiovascular Center, Suita
Yasunaru Kawashima
Affiliation:
From the Department of Cardiovascular Surgery, National Cardiovascular Center, Suita
*
Dr. Osamu Matsuki, Department of Cardiovascular Surgery, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, 565, Japan. Tel.06-833-5012; Fax.06-833-9865.

Summary

A new surgical technique is described to reduce the flow through acquired systemic-pulmonary collateral arteries, a complication which has been recognized as a risk factor in patients undergoing the Fontan operation. When systemic-pulmonary collateral arteries have developed subsequent to previous construction of an ipsilateral Blalock-Taussig shunt or a Glenn anastomosis, and are identified by angiography in advance of the Fontan operation, the technique is indicated as a preparative procedure. It consists of rethoracotomy aimed at isolating the lung from the thoracic wall (peeling), and wrapping of the upper half of the lung with expanded polytetrafluoroethylene sheets to avoid redevelopment of collateral vessels into the lung (wrapping). This decreases the systemic-collateral flow through small vessels which cannot be handled by conventional embolization using catheterization techniques, and permits the Fontan operation to be performed more safely.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1995

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References

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