Authors: Shashi Raj Eliot Rosenkranz Barbara Sears Sethuraman Swaminathan
Publish Date: 2016/05/09
Volume: 37, Issue: 6, Pages: 1111-1118
Abstract
The Fontan operation and its modifications are currently the standard palliation in patients with single ventricle physiology The advantages of extracardiac conduit Fontan operation ECF have previously been described We evaluated the outcome of patients who underwent ECF operation at our center since the year 2000 to assess morbidity mortality and New York Heart Association NYHA functional class in the current era Medical records of 97 patients who underwent ECF operation from November 2000 till October 2013 were reviewed to determine the diagnosis age at surgery surgical technique postoperative complications NYHA class at last followup echocardiographic parameters and most recent Holter monitor results The median age at surgery was 34 years with 4 total deaths until last followup hospital mortality was 1 and mortality after hospital discharge was 3 Seventyeight of the 97 patients 80 underwent fenestrated Fontan surgery Median duration of followup was 39 years IQR 02–122 years At the latest followup 62 patients 67 were determined to be in NYHA class I 25 patients 27 in NYHA class II and 6 6 patients in NYHA class III and the median oxygen saturation was 92 IQR 86–96 There were 15 patients with history of preoperative arrhythmias and 6 of them required pacemaker placement at the time of surgery One patient developed ectopic atrial tachycardia and 1 patient had clinical thromboembolism on followup Systolic function of the single ventricle by transthoracic echocardiogram at the latest followup was described as normal in 77 patients 83 fair in 15 patients 16 and poor in 1 patient 1 The results of our study show that patients who undergo extracardiac conduit Fontan operation in the modern era may have significantly less morbidity and mortality when compared to earlier years
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