Tags

Type your tag names separated by a space and hit enter

Early results of the extracardiac conduit Fontan operation.
J Thorac Cardiovasc Surg. 1999 Apr; 117(4):688-96.JT

Abstract

BACKGROUND

Among the modifications of the Fontan operation, the extracardiac approach may offer the greatest potential for optimizing early postoperative ventricular and pulmonary vascular function, insofar as it can be performed with short periods of normothermic partial cardiopulmonary bypass and without cardioplegic arrest in most cases. In this study, we reviewed our experience with the extracardiac conduit Fontan operation, with a focus on early postoperative outcomes.

METHODS AND RESULTS

Between July 1992 and April 1997, 51 patients (median age 4.9 years) underwent an extracardiac conduit Fontan operation. Median cardiopulmonary bypass time was 92 minutes and has decreased significantly over the course of our experience. Intracardiac procedures were performed in only 5 patients (10%), and the aorta was crossclamped in only 11 (22%). Intraoperative fenestration was performed in 24 patients (47%). There were no early deaths. Fontan failure occurred in 1 patient who was a poor candidate for the Fontan procedure. Transient supraventricular tachyarrhythmias occurred in 5 patients (10%). Median duration of chest tube drainage was 8 days. Factors significantly associated with prolonged resource use (mechanical ventilation, inotropic support, intensive care unit stay, and hospital stay) included longer bypass time and higher Fontan pressure. At a median follow-up of 1.9 years, there was 1 death from bleeding at reoperation.

CONCLUSIONS

The extracardiac conduit Fontan procedure can be performed with minimal mortality and morbidity. Improved results may be related to advantages of the extracardiac approach and improved preservation of ventricular and pulmonary vascular function.

Authors+Show Affiliations

Division of Cardiothoracic Surgery, University of California, San Francisco, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10096963

Citation

Petrossian, E, et al. "Early Results of the Extracardiac Conduit Fontan Operation." The Journal of Thoracic and Cardiovascular Surgery, vol. 117, no. 4, 1999, pp. 688-96.
Petrossian E, Reddy VM, McElhinney DB, et al. Early results of the extracardiac conduit Fontan operation. J Thorac Cardiovasc Surg. 1999;117(4):688-96.
Petrossian, E., Reddy, V. M., McElhinney, D. B., Akkersdijk, G. P., Moore, P., Parry, A. J., Thompson, L. D., & Hanley, F. L. (1999). Early results of the extracardiac conduit Fontan operation. The Journal of Thoracic and Cardiovascular Surgery, 117(4), 688-96.
Petrossian E, et al. Early Results of the Extracardiac Conduit Fontan Operation. J Thorac Cardiovasc Surg. 1999;117(4):688-96. PubMed PMID: 10096963.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early results of the extracardiac conduit Fontan operation. AU - Petrossian,E, AU - Reddy,V M, AU - McElhinney,D B, AU - Akkersdijk,G P, AU - Moore,P, AU - Parry,A J, AU - Thompson,L D, AU - Hanley,F L, PY - 1999/3/30/pubmed PY - 1999/3/30/medline PY - 1999/3/30/entrez SP - 688 EP - 96 JF - The Journal of thoracic and cardiovascular surgery JO - J. Thorac. Cardiovasc. Surg. VL - 117 IS - 4 N2 - BACKGROUND: Among the modifications of the Fontan operation, the extracardiac approach may offer the greatest potential for optimizing early postoperative ventricular and pulmonary vascular function, insofar as it can be performed with short periods of normothermic partial cardiopulmonary bypass and without cardioplegic arrest in most cases. In this study, we reviewed our experience with the extracardiac conduit Fontan operation, with a focus on early postoperative outcomes. METHODS AND RESULTS: Between July 1992 and April 1997, 51 patients (median age 4.9 years) underwent an extracardiac conduit Fontan operation. Median cardiopulmonary bypass time was 92 minutes and has decreased significantly over the course of our experience. Intracardiac procedures were performed in only 5 patients (10%), and the aorta was crossclamped in only 11 (22%). Intraoperative fenestration was performed in 24 patients (47%). There were no early deaths. Fontan failure occurred in 1 patient who was a poor candidate for the Fontan procedure. Transient supraventricular tachyarrhythmias occurred in 5 patients (10%). Median duration of chest tube drainage was 8 days. Factors significantly associated with prolonged resource use (mechanical ventilation, inotropic support, intensive care unit stay, and hospital stay) included longer bypass time and higher Fontan pressure. At a median follow-up of 1.9 years, there was 1 death from bleeding at reoperation. CONCLUSIONS: The extracardiac conduit Fontan procedure can be performed with minimal mortality and morbidity. Improved results may be related to advantages of the extracardiac approach and improved preservation of ventricular and pulmonary vascular function. SN - 0022-5223 UR - https://www.unboundmedicine.com/medline/citation/10096963/Early_results_of_the_extracardiac_conduit_Fontan_operation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5223(99)70288-6 DB - PRIME DP - Unbound Medicine ER -