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Comparison of extracardiac Fontan techniques: pedicled pericardial tunnel versus conduit reconstruction.
J Thorac Cardiovasc Surg. 2003 Mar; 125(3):465-71.JT

Abstract

OBJECTIVE

This study was designed to determine whether either of 2 alternative methods of extracardiac Fontan reconstruction provides superior results.

METHODS

We reviewed 58 consecutive Fontan procedures performed between 1995 and 2001 with a pedicled pericardial tunnel (group P, n = 21) or an extracardiac conduit of polytetrafluoroethylene or allograft aorta (group C, n = 37). Operations were performed with cardiopulmonary bypass at 32 degrees C; an aortic crossclamp was applied in only 6 patients. All group P patients and 33 (89%) group C patients received fenestrations.

RESULTS

The groups were similar in terms of age, weight, anatomy, and preoperative hemodynamics. There were 3 hospital deaths (5%; 70% confidence limit, 2%-30%), all in group C. Median durations of mechanical ventilation (group P, 1 day; group C, 1 day), intensive care unit stay (group P, 3 days; group C, 3 days), chest tube drainage (group P, 8 days; group C, 7 days), and hospitalization (group P, 10 days; group C, 9 days) were not significantly different. There were no late deaths. All patients received warfarin sodium, and there were no late strokes. Before the Fontan procedure, 1 patient in group P and 3 patients in group C required pacemaker implants. Of the 51 surviving patients in sinus rhythm before the Fontan procedure, only 1 patient in group C subsequently required a pacemaker.

CONCLUSIONS

Extracardiac Fontan procedures with either a pericardial baffle or conduit are associated with low operative mortality and low risks of arrhythmia and late thromboembolic complication.

Authors+Show Affiliations

Division of Pediatric Cardiothoracic Surgery, the University of Washington School of Medicine, Seattle, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12658187

Citation

Woods, Ronald K., et al. "Comparison of Extracardiac Fontan Techniques: Pedicled Pericardial Tunnel Versus Conduit Reconstruction." The Journal of Thoracic and Cardiovascular Surgery, vol. 125, no. 3, 2003, pp. 465-71.
Woods RK, Dyamenahalli U, Duncan BW, et al. Comparison of extracardiac Fontan techniques: pedicled pericardial tunnel versus conduit reconstruction. J Thorac Cardiovasc Surg. 2003;125(3):465-71.
Woods, R. K., Dyamenahalli, U., Duncan, B. W., Rosenthal, G. L., & Lupinetti, F. M. (2003). Comparison of extracardiac Fontan techniques: pedicled pericardial tunnel versus conduit reconstruction. The Journal of Thoracic and Cardiovascular Surgery, 125(3), 465-71.
Woods RK, et al. Comparison of Extracardiac Fontan Techniques: Pedicled Pericardial Tunnel Versus Conduit Reconstruction. J Thorac Cardiovasc Surg. 2003;125(3):465-71. PubMed PMID: 12658187.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of extracardiac Fontan techniques: pedicled pericardial tunnel versus conduit reconstruction. AU - Woods,Ronald K, AU - Dyamenahalli,Umesh, AU - Duncan,Brian W, AU - Rosenthal,Geoffrey L, AU - Lupinetti,Flavian M, PY - 2003/3/27/pubmed PY - 2003/4/26/medline PY - 2003/3/27/entrez SP - 465 EP - 71 JF - The Journal of thoracic and cardiovascular surgery JO - J. Thorac. Cardiovasc. Surg. VL - 125 IS - 3 N2 - OBJECTIVE: This study was designed to determine whether either of 2 alternative methods of extracardiac Fontan reconstruction provides superior results. METHODS: We reviewed 58 consecutive Fontan procedures performed between 1995 and 2001 with a pedicled pericardial tunnel (group P, n = 21) or an extracardiac conduit of polytetrafluoroethylene or allograft aorta (group C, n = 37). Operations were performed with cardiopulmonary bypass at 32 degrees C; an aortic crossclamp was applied in only 6 patients. All group P patients and 33 (89%) group C patients received fenestrations. RESULTS: The groups were similar in terms of age, weight, anatomy, and preoperative hemodynamics. There were 3 hospital deaths (5%; 70% confidence limit, 2%-30%), all in group C. Median durations of mechanical ventilation (group P, 1 day; group C, 1 day), intensive care unit stay (group P, 3 days; group C, 3 days), chest tube drainage (group P, 8 days; group C, 7 days), and hospitalization (group P, 10 days; group C, 9 days) were not significantly different. There were no late deaths. All patients received warfarin sodium, and there were no late strokes. Before the Fontan procedure, 1 patient in group P and 3 patients in group C required pacemaker implants. Of the 51 surviving patients in sinus rhythm before the Fontan procedure, only 1 patient in group C subsequently required a pacemaker. CONCLUSIONS: Extracardiac Fontan procedures with either a pericardial baffle or conduit are associated with low operative mortality and low risks of arrhythmia and late thromboembolic complication. SN - 0022-5223 UR - https://www.unboundmedicine.com/medline/citation/12658187/Comparison_of_extracardiac_Fontan_techniques:_pedicled_pericardial_tunnel_versus_conduit_reconstruction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022522302734004 DB - PRIME DP - Unbound Medicine ER -