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Growth potential of U-clip^TM interrupted versus polypropylene running suture anastomosis in congenital cardiac surgery: intermediate term results

^a Clinic for Cardiovascular Surgery, Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland
^b Division of Pediatric Cardiology, Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland

*Corresponding author. Klinik Im Park, Seestrasse 220, Zurich, 8027, Switzerland. Tel.: +41 44 2092552; fax: +41 44 2092512.

E-mail address: pascal.berdat{at}hirslanden.ch (P.A. Berdat).

Although U-clip anastomoses were studied for hemodynamics and patency, their potential for unimpeded growth after congenital cardiovascular surgery has not been investigated yet. In 53 children aged 2.1±3.3 years operated on between March 1998 and August 2005 growth of U-clip (U) vs. polypropylene running sutured (P) anastomoses in coarctation repair (Coarc; n=26), bi-directional Glenn (BDG; n=13) and arterial switch operation (ASO; n=14) was retrospectively analysed. Coarc showed 2.39±4.33 vs. 3.09±2.24 mm of growth during the observation period (21±16 vs. 30±27 months); no growth (0 vs.16%), restenosis (14 vs. 37%) and reinterventions (14 vs. 11%) were similar (all in U vs. P, P=ns). BDG showed 3.68±3.43 vs. 2.50±2.55 mm (P=ns) of growth during 15±5 vs. 29±18 months (P=0.046); no growth (17 vs. 0%), stenosis (0 vs. 14%) and reinterventions (0%) were similar in U vs. P, respectively (P=ns). Main pulmonary artery (MPA) anastomosis in ASO showed 0.28±1.73 vs. 1.30±3.16 mm of growth during 8±14 vs. 28±28 months; no growth (60 vs. 14%), stenosis (50 vs. 63%) and reinterventions (0%) were similar (all in U vs. P, P=ns). Anastomotic growth, stenosis and reintervention rates show no difference between interrupted U-clip and polypropylene running sutured technique in Coarc repair, BDG and MPA anastomosis in ASO.

Key Words: Cardiac surgery; Congenital; Vascular; Growth