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Outcomes of the extracardiac fontan procedure using cardıopulmonary bypass: early results.
Heart Surg Forum. 2014 Jun; 17(3):E173-7.HS

Abstract

BACKGROUND

Although the avoidance of cardiopulmonary bypass during the Fontan procedure has potential advantages, using cardiopulmonary bypass during this procedure has no adverse effects in terms of morbidity and mortality rates. In this study, we assessed the postoperative outcomes of our first 9 patients who have undergone extracardiac Fontan operation by the same surgeon using cardiopulmonary bypass.

METHODS

Between September 2011 and April 2013, 9 consecutive patients (3 males and 6 females) underwent extracardiac Fontan operation. All operations were performed under cardiopulmonary bypass at normothermia by the same surgeon. The age of patients ranged between 4 and 17 (9.8 ± 4.2) years. Previous operations performed on these patients were modified Blalock-Taussig shunt procedure in 2 patients, bidirectional cavopulmonary shunt operation in 6 patients, and pulmonary arterial banding in 1 patient. Except 2 patients who required intracardiac intervention, cross-clamping was not applied. In all patients, the extracardiac Fontan procedure was carried out by interposing an appropriately sized tube graft between the inferior vena cava and right pulmonary artery.

RESULTS

The mean intraoperative Fontan pressure and transpulmonary gradient were 12.3 ± 2.5 and 6.9 ± 2.2 mm Hg, respectively. Intraoperative fenestration was not required. There was no mortality and 7 patients were discharged without complications. Complications included persistent pleural effusion in 1 patient and a transient neurological event in 1 patient. All patients were weaned off mechanical ventilation within 24 hours. The mean arterial oxygen saturation increased from 76.1% ± 5.3% to 93.5% ± 2.2%. All patients were in sinus rhythm postoperatively. Five patients required blood and blood-product transfusions. The mean intensive care unit and hospital stay periods were 2.9 ± 1.7 and 8.2 ± 1.9 days, respectively.

CONCLUSIONS

The extracardiac Fontan operation performed using cardiopulmonary bypass provides satisfactory results in short-term follow-up and is associated with favorable postoperative hemodynamics and morbidity rates.

Authors+Show Affiliations

Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey.Department of Cardiovascular Surgery, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.Department of Cardiovascular Surgery, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.Department of Cardiovascular Surgery, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey.Department of Cardiovascular Surgery, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.Department of Cardiovascular Surgery, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.Department of Cardiovascular Surgery, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.Department of Cardiovascular Surgery, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey Department of Cardiovascular Surgery, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25002396

Citation

Ugurlucan, Murat, et al. "Outcomes of the Extracardiac Fontan Procedure Using Cardıopulmonary Bypass: Early Results." The Heart Surgery Forum, vol. 17, no. 3, 2014, pp. E173-7.
Ugurlucan M, Tuncer EY, Guzelmeric F, et al. Outcomes of the extracardiac fontan procedure using cardıopulmonary bypass: early results. Heart Surg Forum. 2014;17(3):E173-7.
Ugurlucan, M., Tuncer, E. Y., Guzelmeric, F., Kafali, E., Sayin, O. A., Cine, N., Oner, N., Yildirim, A., Ceyran, H., & Basaran, M. (2014). Outcomes of the extracardiac fontan procedure using cardıopulmonary bypass: early results. The Heart Surgery Forum, 17(3), E173-7. https://doi.org/10.1532/HSF98.2014327
Ugurlucan M, et al. Outcomes of the Extracardiac Fontan Procedure Using Cardıopulmonary Bypass: Early Results. Heart Surg Forum. 2014;17(3):E173-7. PubMed PMID: 25002396.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of the extracardiac fontan procedure using cardıopulmonary bypass: early results. AU - Ugurlucan,Murat, AU - Tuncer,Eylem Yayla, AU - Guzelmeric,Fusun, AU - Kafali,Eylul, AU - Sayin,Omer Ali, AU - Cine,Nihat, AU - Oner,Naci, AU - Yildirim,Ayse, AU - Ceyran,Hakan, AU - Basaran,Murat, PY - 2014/7/9/entrez PY - 2014/7/9/pubmed PY - 2015/4/14/medline SP - E173 EP - 7 JF - The heart surgery forum JO - Heart Surg Forum VL - 17 IS - 3 N2 - BACKGROUND: Although the avoidance of cardiopulmonary bypass during the Fontan procedure has potential advantages, using cardiopulmonary bypass during this procedure has no adverse effects in terms of morbidity and mortality rates. In this study, we assessed the postoperative outcomes of our first 9 patients who have undergone extracardiac Fontan operation by the same surgeon using cardiopulmonary bypass. METHODS: Between September 2011 and April 2013, 9 consecutive patients (3 males and 6 females) underwent extracardiac Fontan operation. All operations were performed under cardiopulmonary bypass at normothermia by the same surgeon. The age of patients ranged between 4 and 17 (9.8 ± 4.2) years. Previous operations performed on these patients were modified Blalock-Taussig shunt procedure in 2 patients, bidirectional cavopulmonary shunt operation in 6 patients, and pulmonary arterial banding in 1 patient. Except 2 patients who required intracardiac intervention, cross-clamping was not applied. In all patients, the extracardiac Fontan procedure was carried out by interposing an appropriately sized tube graft between the inferior vena cava and right pulmonary artery. RESULTS: The mean intraoperative Fontan pressure and transpulmonary gradient were 12.3 ± 2.5 and 6.9 ± 2.2 mm Hg, respectively. Intraoperative fenestration was not required. There was no mortality and 7 patients were discharged without complications. Complications included persistent pleural effusion in 1 patient and a transient neurological event in 1 patient. All patients were weaned off mechanical ventilation within 24 hours. The mean arterial oxygen saturation increased from 76.1% ± 5.3% to 93.5% ± 2.2%. All patients were in sinus rhythm postoperatively. Five patients required blood and blood-product transfusions. The mean intensive care unit and hospital stay periods were 2.9 ± 1.7 and 8.2 ± 1.9 days, respectively. CONCLUSIONS: The extracardiac Fontan operation performed using cardiopulmonary bypass provides satisfactory results in short-term follow-up and is associated with favorable postoperative hemodynamics and morbidity rates. SN - 1522-6662 UR - https://www.unboundmedicine.com/medline/citation/25002396/Outcomes_of_the_extracardiac_fontan_procedure_using_cardıopulmonary_bypass:_early_results_ L2 - https://medlineplus.gov/congenitalheartdefects.html DB - PRIME DP - Unbound Medicine ER -