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The mid-term surgical results of Fontan conversion with antiarrhythmia surgery.
Eur J Cardiothorac Surg. 2014 May; 45(5):922-7.EJ

Abstract

OBJECTIVES

We investigated the mid-term surgical results of Fontan conversion with antiarrhythmias surgery and permanent pacemaker implantation, which were complications of a previous Fontan operation.

METHODS

From January 1996 to November 2011, we performed Fontan conversion in 31 of 260 Fontan cases (M:F = 17:14, mean age = 19.0 years). The Fontan conversion from atriopulmonary connection (APC) to extracardiac conduit (ECC) was performed in 20 patients, APC to lateral tunnel in 5 and lateral tunnel to ECC in 6. The clinical outcomes and improvements of arrhythmias were analysed. The types of arrhythmias included atrial flutter in 21 patients, atrial fibrillation with flutter in 4 patients and junctional tachycardia in 3 patients.

RESULTS

Twenty-six patients (83.9%) required antiarrhythmia surgery (isthmus cryoablation = 9, right-sided maze = 13, bilateral maze = 4). In addition, 23 patients (74.2%) received a permanent pacemaker. The New York Heart Association functional class (NYHA Fc) was statistically improved after the surgery during the 6.5-year median follow-up duration (preoperative NYHA Fc = 1.77, postoperative NYHA Fc = 1.13, n = 15, P = 0.001). There were 4 late mortalities. Actuarial 5-year survival was 90.0 ± 5.5%. And freedom from arrhythmia was 91.8 ± 5.5%, at 5 years. Normal sinus rhythm was maintained in 12 patients (38.7%), pacing-dependent rhythm in 10 patients (32.3%) and intermittent pacing-dependent rhythm in 4 patients (12.9%).

CONCLUSIONS

Fontan conversion with antiarrhythmia surgery and permanent pacemaker implantation is safe and improves the clinical outcome and arrhythmias.

Authors+Show Affiliations

Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, South Korea.No affiliation info availableNo affiliation info availableNo 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

24188968

Citation

Jang, Woo Sung, et al. "The Mid-term Surgical Results of Fontan Conversion With Antiarrhythmia Surgery." European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, vol. 45, no. 5, 2014, pp. 922-7.
Jang WS, Kim WH, Choi K, et al. The mid-term surgical results of Fontan conversion with antiarrhythmia surgery. Eur J Cardiothorac Surg. 2014;45(5):922-7.
Jang, W. S., Kim, W. H., Choi, K., Nam, J., Choi, E. S., Lee, J. R., Kim, Y. J., Kwon, B. S., Kim, G. B., & Bae, E. J. (2014). The mid-term surgical results of Fontan conversion with antiarrhythmia surgery. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, 45(5), 922-7. https://doi.org/10.1093/ejcts/ezt511
Jang WS, et al. The Mid-term Surgical Results of Fontan Conversion With Antiarrhythmia Surgery. Eur J Cardiothorac Surg. 2014;45(5):922-7. PubMed PMID: 24188968.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The mid-term surgical results of Fontan conversion with antiarrhythmia surgery. AU - Jang,Woo Sung, AU - Kim,Woong-Han, AU - Choi,Kwangho, AU - Nam,JinHae, AU - Choi,Eun Seok, AU - Lee,Jeong Ryul, AU - Kim,Yong Jin, AU - Kwon,Bo Sang, AU - Kim,Gi Beom, AU - Bae,Eun Jung, Y1 - 2013/11/04/ PY - 2013/11/6/entrez PY - 2013/11/6/pubmed PY - 2015/3/3/medline KW - Antiarrhythmia surgery KW - Fontan conversion KW - Pacemaker implantation SP - 922 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 - 45 IS - 5 N2 - OBJECTIVES: We investigated the mid-term surgical results of Fontan conversion with antiarrhythmias surgery and permanent pacemaker implantation, which were complications of a previous Fontan operation. METHODS: From January 1996 to November 2011, we performed Fontan conversion in 31 of 260 Fontan cases (M:F = 17:14, mean age = 19.0 years). The Fontan conversion from atriopulmonary connection (APC) to extracardiac conduit (ECC) was performed in 20 patients, APC to lateral tunnel in 5 and lateral tunnel to ECC in 6. The clinical outcomes and improvements of arrhythmias were analysed. The types of arrhythmias included atrial flutter in 21 patients, atrial fibrillation with flutter in 4 patients and junctional tachycardia in 3 patients. RESULTS: Twenty-six patients (83.9%) required antiarrhythmia surgery (isthmus cryoablation = 9, right-sided maze = 13, bilateral maze = 4). In addition, 23 patients (74.2%) received a permanent pacemaker. The New York Heart Association functional class (NYHA Fc) was statistically improved after the surgery during the 6.5-year median follow-up duration (preoperative NYHA Fc = 1.77, postoperative NYHA Fc = 1.13, n = 15, P = 0.001). There were 4 late mortalities. Actuarial 5-year survival was 90.0 ± 5.5%. And freedom from arrhythmia was 91.8 ± 5.5%, at 5 years. Normal sinus rhythm was maintained in 12 patients (38.7%), pacing-dependent rhythm in 10 patients (32.3%) and intermittent pacing-dependent rhythm in 4 patients (12.9%). CONCLUSIONS: Fontan conversion with antiarrhythmia surgery and permanent pacemaker implantation is safe and improves the clinical outcome and arrhythmias. SN - 1873-734X UR - https://www.unboundmedicine.com/medline/citation/24188968/The_mid_term_surgical_results_of_Fontan_conversion_with_antiarrhythmia_surgery_ L2 - https://academic.oup.com/ejcts/article-lookup/doi/10.1093/ejcts/ezt511 DB - PRIME DP - Unbound Medicine ER -