Tags

Type your tag names separated by a space and hit enter

Surgical therapy of arrhythmias in single-ventricle patients undergoing Fontan or Fontan conversion.
J Card Surg. 2009 Nov-Dec; 24(6):738-41.JC

Abstract

BACKGROUND

Arrhythmia is detrimental to Fontan hemodynamics. Clinical outcomes among Fontan patients who underwent antiarrhythmic treatment were retrospectively reviewed.

METHODS

From January 1996 to January 2007, 182 patients underwent a Fontan procedure, including Fontan conversion. Thirty-nine of the 182 patients showed various arrhythmias pre- or post-Fontan operations, and were treated surgically including Fontan conversion (18 patients) or medically. The authors analyzed the outcomes of arrhythmia treatments retrospectively.

RESULTS

Thirty-nine patients (21.4%) showed various arrhythmias, such as atrial flutter, atrial fibrillation, junctional rhythm, sinus node dysfunction, or brady tachyarrhythmia pre- or post-Fontan procedure. Follow-up duration was 13.1 +/- 8.7 years (11 months to 325 months).Atrial flutter and fibrillation only developed in 17 patients who received atriopulmonary connection Fontan, and who were treated by Fontan conversion with concomitant procedures such as Cox-maze procedure (two patients), right-side maze and pacemaker implantation (five patients), right atrial isthmus ablation (four patients), right atrial isthmus cryoablation and pacemaker implantation (five patients), and only pacemaker implantation (one patient). The 21 patients who showed arrhythmia at the time of the Fontan procedure underwent the following procedures concomitantly: right atrial isthmus cryoablation with pacemaker implantation (one patient), right atrial isthmus cryoablation (one patient), or pacemaker implantation (nine patients). The remaining 10 patients, who showed junctional rhythm, sinus bradycardia, or intermittent ectopic beats, were managed medically. There were two late mortalities due to protein-losing enteropathy. As a result, 33 patients (89.2%) maintained atrioventricular synchrony, 19 in sinus rhythm and 14 supported by a DDD-type pacemaker. The remaining four patients (10.8%) showed persistent junctional rhythm with a stable hemodynamic status.

CONCLUSIONS

The various arrhythmias in Fontan patients were well controlled by aggressive surgical management.

Authors+Show Affiliations

Department of Cardiothoracic Surgery, Sejong General Hospital, Sejong Heart Institute, Bucheon, Korea.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20078722

Citation

Kwak, Jae Gun, et al. "Surgical Therapy of Arrhythmias in Single-ventricle Patients Undergoing Fontan or Fontan Conversion." Journal of Cardiac Surgery, vol. 24, no. 6, 2009, pp. 738-41.
Kwak JG, Kim WH, Lee JR, et al. Surgical therapy of arrhythmias in single-ventricle patients undergoing Fontan or Fontan conversion. J Card Surg. 2009;24(6):738-41.
Kwak, J. G., Kim, W. H., Lee, J. R., & Kim, Y. J. (2009). Surgical therapy of arrhythmias in single-ventricle patients undergoing Fontan or Fontan conversion. Journal of Cardiac Surgery, 24(6), 738-41. https://doi.org/10.1111/j.1540-8191.2009.00914.x
Kwak JG, et al. Surgical Therapy of Arrhythmias in Single-ventricle Patients Undergoing Fontan or Fontan Conversion. J Card Surg. 2009 Nov-Dec;24(6):738-41. PubMed PMID: 20078722.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical therapy of arrhythmias in single-ventricle patients undergoing Fontan or Fontan conversion. AU - Kwak,Jae Gun, AU - Kim,Woong-Han, AU - Lee,Jeong R, AU - Kim,Yong J, PY - 2010/1/19/entrez PY - 2010/1/19/pubmed PY - 2010/3/23/medline SP - 738 EP - 41 JF - Journal of cardiac surgery JO - J Card Surg VL - 24 IS - 6 N2 - BACKGROUND: Arrhythmia is detrimental to Fontan hemodynamics. Clinical outcomes among Fontan patients who underwent antiarrhythmic treatment were retrospectively reviewed. METHODS: From January 1996 to January 2007, 182 patients underwent a Fontan procedure, including Fontan conversion. Thirty-nine of the 182 patients showed various arrhythmias pre- or post-Fontan operations, and were treated surgically including Fontan conversion (18 patients) or medically. The authors analyzed the outcomes of arrhythmia treatments retrospectively. RESULTS: Thirty-nine patients (21.4%) showed various arrhythmias, such as atrial flutter, atrial fibrillation, junctional rhythm, sinus node dysfunction, or brady tachyarrhythmia pre- or post-Fontan procedure. Follow-up duration was 13.1 +/- 8.7 years (11 months to 325 months).Atrial flutter and fibrillation only developed in 17 patients who received atriopulmonary connection Fontan, and who were treated by Fontan conversion with concomitant procedures such as Cox-maze procedure (two patients), right-side maze and pacemaker implantation (five patients), right atrial isthmus ablation (four patients), right atrial isthmus cryoablation and pacemaker implantation (five patients), and only pacemaker implantation (one patient). The 21 patients who showed arrhythmia at the time of the Fontan procedure underwent the following procedures concomitantly: right atrial isthmus cryoablation with pacemaker implantation (one patient), right atrial isthmus cryoablation (one patient), or pacemaker implantation (nine patients). The remaining 10 patients, who showed junctional rhythm, sinus bradycardia, or intermittent ectopic beats, were managed medically. There were two late mortalities due to protein-losing enteropathy. As a result, 33 patients (89.2%) maintained atrioventricular synchrony, 19 in sinus rhythm and 14 supported by a DDD-type pacemaker. The remaining four patients (10.8%) showed persistent junctional rhythm with a stable hemodynamic status. CONCLUSIONS: The various arrhythmias in Fontan patients were well controlled by aggressive surgical management. SN - 1540-8191 UR - https://www.unboundmedicine.com/medline/citation/20078722/Surgical_therapy_of_arrhythmias_in_single_ventricle_patients_undergoing_Fontan_or_Fontan_conversion_ L2 - https://doi.org/10.1111/j.1540-8191.2009.00914.x DB - PRIME DP - Unbound Medicine ER -