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Impact of Fontan conversion with arrhythmia surgery and pacemaker therapy.
Eur J Cardiothorac Surg. 2011 Oct; 40(4):1007-10.EJ

Abstract

OBJECTIVE

In the long-term period after Fontan operation, atrial arrhythmia was one of the important factors to decide the postoperative quality of life. We reviewed the impact of Fontan conversion with arrhythmia surgery and pacemaker therapy.

METHODS

Thirty-eight patients underwent Fontan conversion using extracardiac conduit from 1992, and 22 patients with atrial arrhythmia underwent maze procedure simultaneously using cryoablation or radiofrequency ablation and epicardial DDD pacemaker implantation and 16 patients had regular 'sinus' rhythm before Fontan conversion. Mean follow-up period was 52 months. Pre- and postoperative clinical course were analyzed. Average weight, age at Fontan conversion, and years after first Fontan operation were 49.0 kg, 25.8 years old, 14.7 years, respectively. Nineteen percent of patients were in New York Heart Association class I (NYHA I), and 74% of patients were in NYHA II, and 7% were in NYHA III, respectively.

RESULTS

Except three early deaths, actual survival rate at 1 year and 5 years were 80% and 64%, respectively. In survivors, 80% of the patients obtained regular heart rhythm including artificial pacemaker rhythm, although only 43% of the patients had regular 'sinus' rhythm before the Fontan conversion. Postoperative average cardiothoracic ratio and oxygen saturation (SpO(2)) were 50% and 94%, and 74% of patients were in NYHA I and 26% were in NYHA II, respectively, after Fontan conversion.

CONCLUSIONS

Mid-term results of Fontan conversion with arrhythmia surgery and pacemaker therapy were acceptable. Restoration of regular rhythm might improve the postoperative NYHA status and the activity of the daily life.

Authors+Show Affiliations

Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan. shiramat@hij.twmu.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

21354811

Citation

Hiramatsu, Takeshi, et al. "Impact of Fontan Conversion With Arrhythmia Surgery and Pacemaker Therapy." European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, vol. 40, no. 4, 2011, pp. 1007-10.
Hiramatsu T, Iwata Y, Matsumura G, et al. Impact of Fontan conversion with arrhythmia surgery and pacemaker therapy. Eur J Cardiothorac Surg. 2011;40(4):1007-10.
Hiramatsu, T., Iwata, Y., Matsumura, G., Konuma, T., & Yamazaki, K. (2011). Impact of Fontan conversion with arrhythmia surgery and pacemaker therapy. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, 40(4), 1007-10. https://doi.org/10.1016/j.ejcts.2011.01.022
Hiramatsu T, et al. Impact of Fontan Conversion With Arrhythmia Surgery and Pacemaker Therapy. Eur J Cardiothorac Surg. 2011;40(4):1007-10. PubMed PMID: 21354811.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of Fontan conversion with arrhythmia surgery and pacemaker therapy. AU - Hiramatsu,Takeshi, AU - Iwata,Yusuke, AU - Matsumura,Goki, AU - Konuma,Takeshi, AU - Yamazaki,Kenji, Y1 - 2011/02/26/ PY - 2010/09/01/received PY - 2011/01/05/revised PY - 2011/01/06/accepted PY - 2011/3/1/entrez PY - 2011/3/1/pubmed PY - 2012/2/18/medline SP - 1007 EP - 10 JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JO - Eur J Cardiothorac Surg VL - 40 IS - 4 N2 - OBJECTIVE: In the long-term period after Fontan operation, atrial arrhythmia was one of the important factors to decide the postoperative quality of life. We reviewed the impact of Fontan conversion with arrhythmia surgery and pacemaker therapy. METHODS: Thirty-eight patients underwent Fontan conversion using extracardiac conduit from 1992, and 22 patients with atrial arrhythmia underwent maze procedure simultaneously using cryoablation or radiofrequency ablation and epicardial DDD pacemaker implantation and 16 patients had regular 'sinus' rhythm before Fontan conversion. Mean follow-up period was 52 months. Pre- and postoperative clinical course were analyzed. Average weight, age at Fontan conversion, and years after first Fontan operation were 49.0 kg, 25.8 years old, 14.7 years, respectively. Nineteen percent of patients were in New York Heart Association class I (NYHA I), and 74% of patients were in NYHA II, and 7% were in NYHA III, respectively. RESULTS: Except three early deaths, actual survival rate at 1 year and 5 years were 80% and 64%, respectively. In survivors, 80% of the patients obtained regular heart rhythm including artificial pacemaker rhythm, although only 43% of the patients had regular 'sinus' rhythm before the Fontan conversion. Postoperative average cardiothoracic ratio and oxygen saturation (SpO(2)) were 50% and 94%, and 74% of patients were in NYHA I and 26% were in NYHA II, respectively, after Fontan conversion. CONCLUSIONS: Mid-term results of Fontan conversion with arrhythmia surgery and pacemaker therapy were acceptable. Restoration of regular rhythm might improve the postoperative NYHA status and the activity of the daily life. SN - 1873-734X UR - https://www.unboundmedicine.com/medline/citation/21354811/Impact_of_Fontan_conversion_with_arrhythmia_surgery_and_pacemaker_therapy_ L2 - https://academic.oup.com/ejcts/article-lookup/doi/10.1016/j.ejcts.2011.01.022 DB - PRIME DP - Unbound Medicine ER -