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The extracardiac lateral tunnel Fontan, constructed with bovine pericardium: comparison with the extracardiac conduit Fontan.
Am Heart J. 2006 Apr; 151(4):928-33.AH

Abstract

BACKGROUND

The Fontan procedure performed with an extracardiac conduit (ECC) has gained wide acceptance as an alternative to the intracardiac lateral tunnel because it avoids placement of extensive atrial suture lines and use of prosthetic material in the systemic circulation. The extracardiac lateral tunnel (ELT) is a modification of the Fontan procedure which uses pericardium and the external surface of the atrium to create a conduit from the inferior vena cava to the pulmonary artery. This surgery theoretically avoids disruption of intra-atrial conduction by eschewing endocardial suturing while maintaining conduit growth potential and the ability to easily create a fenestration to the systemic circulation.

METHODS

We retrospectively analyzed the short-term outcome of 96 consecutive patients who underwent an extracardiac Fontan procedure. An ELT using bovine pericardium was performed in 59 patients, whereas 37 patients received a traditional ECC.

RESULTS

The 2 groups were similar with respect to age (P = .96), body surface area (P = .54), number of preoperative Fontan risk factors (P = .43), and ventricular morphology (P = .72). There were no significant differences in the following outcome variables between the ELT and the traditional ECC: length of hospitalization (P = .73), duration of chest tube drainage (P = .48), abnormal rhythm at time of discharge (P = .27), and mortality (P = .63).

CONCLUSIONS

The ELT Fontan can be performed with a low risk of mortality and complications. The results are equivalent to the traditional ECC procedure. The theoretical advantages of the procedure suggest that it should be considered a useful modification of Fontan surgery.

Authors+Show Affiliations

Department of Pediatrics, The Children's Medical Center, University of Texas Southwestern Medical Center, Dallas, TX, USA. matt.lemler@childrens.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16569566

Citation

Lemler, Matthew S., et al. "The Extracardiac Lateral Tunnel Fontan, Constructed With Bovine Pericardium: Comparison With the Extracardiac Conduit Fontan." American Heart Journal, vol. 151, no. 4, 2006, pp. 928-33.
Lemler MS, Ramaciotti C, Stromberg D, et al. The extracardiac lateral tunnel Fontan, constructed with bovine pericardium: comparison with the extracardiac conduit Fontan. Am Heart J. 2006;151(4):928-33.
Lemler, M. S., Ramaciotti, C., Stromberg, D., Scott, W. A., & Leonard, S. R. (2006). The extracardiac lateral tunnel Fontan, constructed with bovine pericardium: comparison with the extracardiac conduit Fontan. American Heart Journal, 151(4), 928-33.
Lemler MS, et al. The Extracardiac Lateral Tunnel Fontan, Constructed With Bovine Pericardium: Comparison With the Extracardiac Conduit Fontan. Am Heart J. 2006;151(4):928-33. PubMed PMID: 16569566.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The extracardiac lateral tunnel Fontan, constructed with bovine pericardium: comparison with the extracardiac conduit Fontan. AU - Lemler,Matthew S, AU - Ramaciotti,Claudio, AU - Stromberg,Daniel, AU - Scott,William A, AU - Leonard,Steven R, PY - 2005/04/06/received PY - 2005/06/08/accepted PY - 2006/3/30/pubmed PY - 2006/4/25/medline PY - 2006/3/30/entrez SP - 928 EP - 33 JF - American heart journal JO - Am Heart J VL - 151 IS - 4 N2 - BACKGROUND: The Fontan procedure performed with an extracardiac conduit (ECC) has gained wide acceptance as an alternative to the intracardiac lateral tunnel because it avoids placement of extensive atrial suture lines and use of prosthetic material in the systemic circulation. The extracardiac lateral tunnel (ELT) is a modification of the Fontan procedure which uses pericardium and the external surface of the atrium to create a conduit from the inferior vena cava to the pulmonary artery. This surgery theoretically avoids disruption of intra-atrial conduction by eschewing endocardial suturing while maintaining conduit growth potential and the ability to easily create a fenestration to the systemic circulation. METHODS: We retrospectively analyzed the short-term outcome of 96 consecutive patients who underwent an extracardiac Fontan procedure. An ELT using bovine pericardium was performed in 59 patients, whereas 37 patients received a traditional ECC. RESULTS: The 2 groups were similar with respect to age (P = .96), body surface area (P = .54), number of preoperative Fontan risk factors (P = .43), and ventricular morphology (P = .72). There were no significant differences in the following outcome variables between the ELT and the traditional ECC: length of hospitalization (P = .73), duration of chest tube drainage (P = .48), abnormal rhythm at time of discharge (P = .27), and mortality (P = .63). CONCLUSIONS: The ELT Fontan can be performed with a low risk of mortality and complications. The results are equivalent to the traditional ECC procedure. The theoretical advantages of the procedure suggest that it should be considered a useful modification of Fontan surgery. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/16569566/The_extracardiac_lateral_tunnel_Fontan_constructed_with_bovine_pericardium:_comparison_with_the_extracardiac_conduit_Fontan_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(05)00617-4 DB - PRIME DP - Unbound Medicine ER -