Total cavopulmonary connection with a new restorative vascular graft: results at 2 years.

Bockeria, Leo; Carrel, Thierry; Lemaire, Anais; Makarenko, Vladimir; Kim, Alex; Shatalov, Konstantin; Cox, Martijn; Svanidze, Oleg (2020). Total cavopulmonary connection with a new restorative vascular graft: results at 2 years. Journal of thoracic disease, 12(8), pp. 4168-4173. AME Publishing Company 10.21037/jtd-19-739

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Background

To present a 2-year follow-up regarding safety and hemodynamic performance of a new restorative vascular graft used as extracardiac cavo-pulmonary connection in patients with univentricular congenital heart malformations.

Methods

The graft was implanted in five patients (aged 4-12 years) as extracardiac connection between the inferior vena cava and the pulmonary artery. The conduit consists of a bioabsorbable polymer-based implant able to generate endogenous tissue restoration leading to a fully functional neo-vessel while the polymer progressively absorbs. All patients have reached more than 24 months following surgery and underwent echocardiography and magnetic resonance imaging.

Results

All patients are doing well at 24 months follow-up, with no graft-related serious adverse events. Transthoracic echocardiography demonstrated adequate function of the conduit in all patients while magnetic resonance imaging showed anatomical and functional stability of the restorative grafts.

Conclusions

The new restorative conduit has been successfully used for the second step of the Fontan procedure as extracardiac total cavopulmonary connection. The results are promising because they suggest that complete transformation of a bioabsorbable polymer and replacement through endogenous tissue may represent a major advantage in the treatment of congenital heart disease patients. Further monitoring will allow to evaluate the long-term behavior of this new graft, in terms of clinical and hemodynamic performance, thrombogenicity and ability to grow.

Interest & Impact

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