Extracardiac total cavopulmonary connection using a tissue-engineered graft

Yukihisa Isomatsu, Toshiharu Shin'oka, Goki Matsumura, Narutoshi Hibino, Takeshi Konuma, Masayoshi Nagatsu, Hiromi Kurosawa

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Extracardiac and lateral tunnel total cavopulmonary connection are currently 2 major options for patients with a single ventricle physiology. However, each procedure has some disadvantages over the other. We developed a new technique of extracardiac total cavopulmonary connection using a tissue-engineered graft to overcome some of the disadvantages previously associated with both the extracardiac and lateral tunnel procedures. Methods: Between February 2001 and October 2002, 8 patients underwent an extracardiac total cavopulmonary connection using a tissue-engineered graft in our institution. Collected bone marrow cells (1 × 108 mononucleocytes) from a patient (∼ 1-4 mL/kg body weight) were seeded onto a biodegradable scaffold composed of polycaprolactone-polylactic acid copolymer reinforced with woven polylactic acid. After a 2- to 4-hour cultivation, the seeded scaffold was implanted as an extracardiac conduit during the total cavopulmonary connection operation. Results: There were no hospital or late deaths. At a mean follow-up of 13.4 months (range 4-25 months), all patients are alive and asymptomatic with no need for repeat surgery. A postoperative catheter examination or computed tomography showed all tissue-engineered grafts to be patent and revealed no stenosis, obstruction, or aneurysmal change in the 8 patients. Conclusion: We believe that extracardiac total cavopulmonary connection using a tissue-engineered graft has the potential to overcome some of the disadvantages previously associated with extracardiac or lateral tunnel total cavopulmonary connection. However, an extended follow-up period is required to clarify the long-term clinical outcome for the tissue-engineered graft.

Original languageEnglish (US)
Pages (from-to)1958-1962
Number of pages5
JournalJournal of Thoracic and Cardiovascular Surgery
Volume126
Issue number6
DOIs
StatePublished - Dec 2003
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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