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KMID : 0857220050090020317
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Journal of the Korean Pediatric Cardiology Society
2005 Volume.9 No. 2 p.317 ~ p.325
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A Method of Preventing Perigraft Leak from a Polytetrafluoroethylene Blalock-Taussig Shunt
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Yang Ji-Hyuk
Lee Ho-Seok
Jun Tae-Gook
Park Pyo-Won
Sung Ki-Ick
Huh June
Kang I-Seok
Lee Heung-Jae
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Abstract
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Purpose: Perigraft seroma and excessive fluid leaks are well known complications after the use of expanded polytetrafluoroethylene(ePTFE, Gore-Texⓡ) graft. The purpose of this study is to evaluate the effectiveness of precoating the grafts with fibrin glue in the patients underwent a modified Blalock-Taussig shunt.
Methods: Among 51 consecutive infants underwent modified Blalock-Taussig shunt between June 2000 and August 2003, 49 patients underwent 53 shunt procedures through thoracotomy were included for analysis. Their median age was 0.9 months(2 days-5.9 months), median body weight was 3.5(2.2-7.9) kg. The ePTFE grafts precoated with fibrin glue were used in 20 procedures. Perioperative variables of the precoated group were compared with those of a control group(n=33) using t-test and Fisher’s exact test.
Results: There was no operative mortality in the both groups. No significant difference between the groups could be found in the preoperative variables, postoperative morbidity, and the incidence of perigraft seroma, which developed only in 1 case in the control group. The size of the grafts was significantly smaller in the precoated group(P <0.01). The total amount of pleural drainage per body weight of the precoated group was significantly less than that of the control group(19.7±25.2 versus 5.5±4.9 mL/kg; P<0.01).
Conclusion: Precoating an ePTFE graft with fibrin glue may reduce perigraft leak after a modified Blalock-Taussig shunt, although the impact of the size of the graft used and the native pulmonary artery requires further investigation.
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KEYWORD
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Blood vessel prosthesis, Polytetrafluoroethylene, Postoperative complications, Tissue adhesives
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