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Fontan conversion with arrhythmia surgery.
Eur J Cardiothorac Surg. 2005 Feb; 27(2):250-7.EJ

Abstract

OBJECTIVE

Hemodynamic abnormalities and refractory atrial arrhythmias in patients late after the Fontan operation result in significant morbidity and mortality. We reviewed our experience with Fontan conversion and concomitant arrhythmia surgery.

METHODS

Between January 1996 and February 2004, 16 patients underwent Fontan conversion and arrhythmia surgery. Mean age at the initial Fontan operation was 5.1+/-3.5 (range: 2-15) years and mean age at Fontan conversion was 17.0+/-5.8 (range: 6-30). The initial Fontan operations were atriopulmonary connections in 14 patients, extracardiac lateral tunnel in 1, and intracardiac lateral tunnel in 1. The types of arrhythmia included atrial flutter in 10 patients and atrial fibrillation in 3. Fontan conversion operation was performed with intracardiac lateral tunnel in 5 patients and extracardiac conduit in 11. Arrhythmia surgery included isthmus cryoablation in 10 patients and right-sided maze in 3.

RESULTS

There has been no mortality. At Fontan conversion operation, 7 patients required permanent pacemaker. All patients have improved to New York Heart Association class I or II. With a mean follow-up of 26.9+/-30.6 (range:1-87) months, 16 patients had sinus rhythm, 2 patients had transient atrial flutter which was well controlled, and 2 patients required permanent pacemaker during follow-up.

CONCLUSIONS

Fontan conversion with concomitant arrhythmia surgery and permanent pacemaker placement is safe, improves New York Heart Association functional class, and has a low incidence of recurrent arrhythmias. In most patients, concomitant permanent pacemakers are needed.

Authors+Show Affiliations

Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu Seoul 110-799, Korea.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

15691678

Citation

Kim, Woong-Han, et al. "Fontan Conversion With Arrhythmia Surgery." European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, vol. 27, no. 2, 2005, pp. 250-7.
Kim WH, Lim HG, Lee JR, et al. Fontan conversion with arrhythmia surgery. Eur J Cardiothorac Surg. 2005;27(2):250-7.
Kim, W. H., Lim, H. G., Lee, J. R., Rho, J. R., Bae, E. J., Noh, C. I., Yoon, Y. S., & Kim, Y. J. (2005). Fontan conversion with arrhythmia surgery. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, 27(2), 250-7.
Kim WH, et al. Fontan Conversion With Arrhythmia Surgery. Eur J Cardiothorac Surg. 2005;27(2):250-7. PubMed PMID: 15691678.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fontan conversion with arrhythmia surgery. AU - Kim,Woong-Han, AU - Lim,Hong Gook, AU - Lee,Jeong Ryul, AU - Rho,Joon Ryang, AU - Bae,Eun Jung, AU - Noh,Chung Il, AU - Yoon,Yong Soo, AU - Kim,Yong Jin, PY - 2004/08/20/received PY - 2004/10/05/revised PY - 2004/10/18/accepted PY - 2005/2/5/pubmed PY - 2005/5/25/medline PY - 2005/2/5/entrez SP - 250 EP - 7 JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JO - Eur J Cardiothorac Surg VL - 27 IS - 2 N2 - OBJECTIVE: Hemodynamic abnormalities and refractory atrial arrhythmias in patients late after the Fontan operation result in significant morbidity and mortality. We reviewed our experience with Fontan conversion and concomitant arrhythmia surgery. METHODS: Between January 1996 and February 2004, 16 patients underwent Fontan conversion and arrhythmia surgery. Mean age at the initial Fontan operation was 5.1+/-3.5 (range: 2-15) years and mean age at Fontan conversion was 17.0+/-5.8 (range: 6-30). The initial Fontan operations were atriopulmonary connections in 14 patients, extracardiac lateral tunnel in 1, and intracardiac lateral tunnel in 1. The types of arrhythmia included atrial flutter in 10 patients and atrial fibrillation in 3. Fontan conversion operation was performed with intracardiac lateral tunnel in 5 patients and extracardiac conduit in 11. Arrhythmia surgery included isthmus cryoablation in 10 patients and right-sided maze in 3. RESULTS: There has been no mortality. At Fontan conversion operation, 7 patients required permanent pacemaker. All patients have improved to New York Heart Association class I or II. With a mean follow-up of 26.9+/-30.6 (range:1-87) months, 16 patients had sinus rhythm, 2 patients had transient atrial flutter which was well controlled, and 2 patients required permanent pacemaker during follow-up. CONCLUSIONS: Fontan conversion with concomitant arrhythmia surgery and permanent pacemaker placement is safe, improves New York Heart Association functional class, and has a low incidence of recurrent arrhythmias. In most patients, concomitant permanent pacemakers are needed. SN - 1010-7940 UR - https://www.unboundmedicine.com/medline/citation/15691678/Fontan_conversion_with_arrhythmia_surgery_ L2 - https://academic.oup.com/ejcts/article-lookup/doi/10.1016/j.ejcts.2004.10.059 DB - PRIME DP - Unbound Medicine ER -