| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The Annals of Thoracic Surgery, Vol 58, 945-951, Copyright © 1994 by The Society of Thoracic Surgeons
ML Jacobs and WI Norwood Jr
The mortality rate of the Fontan operation for heart malformations with a
single or dominant ventricle has been reduced by dividing the procedure
into two stages. The hemi-Fontan procedure allows early reduction of the
volume work of the single ventricle and remodeling of ventricular geometry
before a completion Fontan operation. Despite the improvement of survival
with this strategy (8% mortality for completion Fontan versus 16% mortality
for primary Fontan operation), morbidity related to serous effusions
remains substantial. Further technical modifications have been undertaken
in an effort to reduce morbidity and further reduce mortality. From January
1990 through June 1993, 200 patients underwent completion Fontan procedures
after previous hemi- Fontan operations. Mean age was 23 months, and 157
patients were less than 24 months of age. Diagnoses were hypoplastic left
heart syndrome (127 patients), tricuspid atresia (19 patients), single left
ventricle (17 patients), complex double-outlet right ventricle (16
patients), pulmonary atresia with intact ventricular septum (8 patients),
and other (13 patients). Overall, early mortality rate was 8% (16
patients). In the last 112 patients, the procedure was modified technically
by creating one or more fenestrations in the baffle used to separate
systemic venous blood from pulmonary venous blood (36 patients), or by
excluding one or more hepatic veins from the systemic venous pathway (76
patients). Early mortality for these 112 patients was reduced to 4.5% (5
patients). Substantial morbidity from serous effusions occurred at a rate
of 45% (35 of 78 patients) among survivors who had received neither
technical modification.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Fontan operation: influence of modifications on morbidity and mortality
Division of Cardiothoracic Surgery, Children's Hospital of Philadelphia, PA 19104.
This article has been cited by other articles:
|
|
 |
|
  P. Khairy, S. M. Fernandes, J. E. Mayer Jr, J. K. Triedman, E. P. Walsh, J. E. Lock, and M. J. Landzberg Long-Term Survival, Modes of Death, and Predictors of Mortality in Patients With Fontan Surgery Circulation, January 1, 2008; 117(1): 85 - 92. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. J. Bradley, T. Karamlou, A. Kulik, B. Mitrovic, T. Vigneswaran, S. Jaffer, P. D. Glasgow, W. G. Williams, G. S. Van Arsdell, and B. W. McCrindle Determinants of repair type, reintervention, and mortality in 393 children with double-outlet right ventricle. J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 967 - 973.e6. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Sallehuddin, A. Mesned, M. Barakati, M. A. Fayyadh, F. Fadley, and Z. Al-Halees Fontan completion without surgery Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 195 - 200. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Pizarro, T. Mroczek, S. S. Gidding, J. D. Murphy, and W. I. Norwood Fontan Completion in Infants Ann. Thorac. Surg., June 1, 2006; 81(6): 2243 - 2249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Alphonso, M. Baghai, P. Sundar, R. Tulloh, C. Austin, and D. Anderson Intermediate-term outcome following the fontan operation: a survival, functional and risk-factor analysis Eur. J. Cardiothorac. Surg., October 1, 2005; 28(4): 529 - 535. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. N. Kavarana, S. Pagni, M. R. Recto, W. L. Sobczyk, T. Yeh Jr, M. Mitchell, and E. H. Austin III Seven-Year Clinical Experience With the Extracardiac Pedicled Pericardial Fontan Operation Ann. Thorac. Surg., July 1, 2005; 80(1): 37 - 43. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Jayakumar, L. J. Addonizio, M. R. Kichuk-Chrisant, M. E. Galantowicz, J. M. Lamour, J. M. Quaegebeur, and D. T. Hsu Cardiac transplantation after the Fontan or Glenn procedure J. Am. Coll. Cardiol., November 16, 2004; 44(10): 2065 - 2072. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. L. Border, A. U. Syed, E. C. Michelfelder, P. Khoury, K. C. Uzark, P. B. Manning, and J. M. Pearl Impaired systemic ventricular relaxation affects postoperative short-term outcome in Fontan patients J. Thorac. Cardiovasc. Surg., January 1, 2004; 126(6): 1760 - 1764. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. P. Kumar, C. S. Rubinstein, J. M. Simsic, A. B. Taylor, J. P. Saul, and S. M. Bradley Lateral tunnel versus extracardiac conduit fontan procedure: a concurrent comparison Ann. Thorac. Surg., November 1, 2003; 76(5): 1389 - 1397. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. P. McGuirk, D. S. Winlaw, S. M. Langley, O. F. Stumper, J. V. de Giovanni, J. G. Wright, W. J. Brawn, and D. J. Barron The impact of ventricular morphology on midterm outcome following completion total cavopulmonary connection Eur. J. Cardiothorac. Surg., July 1, 2003; 24(1): 37 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. W. Brown, M. Ruzmetov, Y. Okada, P. Vijay, and M. W. Turrentine Surgical results in patients with double outlet right ventricle: a 20-year experience Ann. Thorac. Surg., November 1, 2001; 72(5): 1630 - 1635. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. T. Fedderly, B. N. Whitstone, S. J. Frisbee, J. S. Tweddell, and S. B. Litwin Factors Related to Pleural Effusions After Fontan Procedure in the Era of Fenestration Circulation, September 18, 2001; 104(90001): I-148 - 151. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Gaca, W. I. Douglas, and S. D. Barnes Anesthetic Implications of the Fontan Procedure for Single Ventricle Physiology Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2001; 5(1): 31 - 39. [Abstract] [PDF]
|
|
|
|
|
|
K. Takeuchi, F. X. McGowan Jr, A. M. Moran, D. Zurakowski, J. E. Mayer Jr, R. A. Jonas, and P. J. del Nido Surgical outcome of double-outlet right ventricle with subpulmonary VSD Ann. Thorac. Surg., January 1, 2001; 71(1): 49 - 53. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. P.R. Brizard, N. Goussef, J. C. Chachques, and A. F. Carpentier Model of complete separation of the hepatic veins from the systemic venous system Ann. Thorac. Surg., December 1, 2000; 70(6): 2096 - 2101. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. I. Cohen, N. D. Bridges, J. W. Gaynor, T. M. Hoffman, G. Wernovsky, V. L. Vetter, T. L. Spray, and L. A. Rhodes Modifications to the cavopulmonary anastomosis do not eliminate early sinus node dysfunction J. Thorac. Cardiovasc. Surg., November 1, 2000; 120(5): 891 - 901. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Kumar, S. Samuel, K S. Sai, M. Vakamudi, R. Saldanha, K. R. Balakrishnan, R. Kumar, S. Samuel, K S. Sai, M. Vakamudi, et al. Extracardiac Fontan/Kawashima Procedure Without Cardiopulmonary Bypass Asian Cardiovasc Thorac Ann, September 1, 2000; 8(3): 264 - 265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. S. Van Arsdell, B. W. McCrindle, K. D. Einarson, K.-J. Lee, E. Oag, C. A. Caldarone, and W. G. Williams Interventions associated with minimal Fontan mortality Ann. Thorac. Surg., August 1, 2000; 70(2): 568 - 574. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Bando, M. W. Turrentine, H. J. Park, T. G. Sharp, V. Scavo, and J. W. Brown Evolution of the Fontan procedure in a single center Ann. Thorac. Surg., June 1, 2000; 69(6): 1873 - 1879. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Airan, R. Sharma, S. K. Choudhary, S. R. Mohanty, A. Bhan, U. K. Chowdhari, R. Juneja, S. S. Kothari, A. Saxena, and P. Venugopal Univentricular repair: is routine fenestration justified? Ann. Thorac. Surg., June 1, 2000; 69(6): 1900 - 1906. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. D. Mainwaring, E. Capparelli, K. Schell, M. Acosta, and J. C. Nelson Pharmacokinetic Evaluation of Triiodothyronine Supplementation in Children After Modified Fontan Procedure Circulation, March 28, 2000; 101(12): 1423 - 1429. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Lamberti and K. C. Uzark The Fontan operation Ann. Thorac. Surg., May 1, 1999; 67(5): 1523 - 1524. [Full Text] [PDF]
|
|
|
|
|
|
E. Petrossian, V. M. Reddy, D. B. McElhinney, G. P. Akkersdijk, P. Moore, A. J. Parry, L. D. Thompson, and F. L. Hanley EARLY RESULTS OF THE EXTRACARDIAC CONDUIT FONTAN OPERATION J. Thorac. Cardiovasc. Surg., April 1, 1999; 117(4): 688 - 696. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Okabe, N. Nagata, Y. Kaneko, J. Kobayashi, S. Kanemoto, and T. Takaoka EXTRACARDIAC CAVOPULMONARY CONNECTION OF FONTAN PROCEDURE WITH AUTOLOGOUS PEDICLED PERICARDIUM WITHOUT CARDIOPULMONARY BYPASS J. Thorac. Cardiovasc. Surg., December 1, 1998; 116(6): 1073 - 1075. [Full Text] [PDF]
|
|
|
|
|
|
R. M. Freedom Subaortic obstruction and the fontan operation Ann. Thorac. Surg., August 1, 1998; 66(2): 649 - 652. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Tofeig, K P Walsh, and R Arnold Transcatheter occlusion of a post-Fontan residual hepatic vein to pulmonary venous atrium communication using the Amplatzer septal occluder Heart, June 1, 1998; 79(6): 624 - 626. [Abstract] [Full Text]
|
|
|
|
|
|
C. H. Zachary, M. L. Jacobs, S. Apostolopoulou, and M. A. Fogel One-Lung Fontan Operation: Hemodynamics and Surgical Outcome Ann. Thorac. Surg., January 1, 1998; 65(1): 171 - 175. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Amodeo, L. Galletti, S. Marianeschi, S. Picardo, S. Giannico, P. Di Renzi, and C. Marcelletti EXTRACARDIAC FONTAN OPERATION FOR COMPLEX CARDIAC ANOMALIES: SEVEN YEARS' EXPERIENCE J. Thorac. Cardiovasc. Surg., December 1, 1997; 114(6): 1020 - 1031. [Abstract] [Full Text]
|
|
|
|
|
|
S. Kleinert, T. Sano, R.G. Weintraub, R.B.B. Mee, T.R. Karl, and J.L. Wilkinson Anatomic Features and Surgical Strategies in Double-Outlet Right Ventricle Circulation, August 19, 1997; 96(4): 1233 - 1239. [Abstract] [Full Text]
|
|
|
|
|
|
T. C. Koutlas, J. W. Gaynor, S. C. Nicolson, J. M. Steven, G. Wernovsky, and T. L. Spray Modified Ultrafiltration Reduces Postoperative Morbidity After Cavopulmonary Connection Ann. Thorac. Surg., July 1, 1997; 64(1): 37 - 42. [Abstract] [Full Text]
|
|
|
|
|
|
M. J. Shah, J. Rychik, M. A. Fogel, J. D. Murphy, and M. L. Jacobs Pulmonary AV Malformations After Superior Cavopulmonary Connection: Resolution After Inclusion of Hepatic Veins in the Pulmonary Circulation Ann. Thorac. Surg., April 1, 1997; 63(4): 960 - 963. [Abstract] [Full Text]
|
|
|
|
|
|
H. K. Najm, W. G. Williams, J. G. Coles, I. M. Rebeyka, and R. M. Freedom Pulmonary Atresia With Intact Ventricular Septum: Results of the Fontan Procedure Ann. Thorac. Surg., March 1, 1997; 63(3): 669 - 675. [Abstract] [Full Text]
|
|
|
|
|
|
P. A. Penkoske Hypoplastic Left Heart Syndrome Ann. Thorac. Surg., January 1, 1997; 63(1): 285 - 286. [Full Text]
|
|
|
|
|
|
M. L. Jacobs, J. Rychik, J. J. Rome, S. Apostolopoulou, C. Pizarro, J. D. Murphy, and W. I. Norwood Jr Early Reduction of the Volume Work of the Single Ventricle: The Hemi-Fontan Operation Ann. Thorac. Surg., August 1, 1996; 62(2): 456 - 461. [Abstract] [Full Text]
|
|
|
|
|
|
K. Bando, M. W. Turrentine, K. Sun, T. G. Sharp, R. L. Caldwell, R. K. Darragh, G. J. Ensing, T. M. Cordes, T. Flaspohler, and J. W. Brown Surgical Management of Hypoplastic Left Heart Syndrome Ann. Thorac. Surg., July 1, 1996; 62(1): 70 - 76. [Abstract] [Full Text]
|
|
|
|
|
|
M. K. Reed, S. R. Leonard, T. M. Zellers, and H. Nikaidoh Major Intrahepatic Venovenous Fistulas After a Modified Fontan Operation Ann. Thorac. Surg., February 1, 1996; 61(2): 713 - 715. [Abstract] [Full Text]
|
|
|
|
|
|
J. Rychik, M. L. Jacobs, and W. I. Norwood Jr Acute Changes in Left Ventricular Geometry After Volume Reduction Operation Ann. Thorac. Surg., November 1, 1995; 60(5): 1267 - 1273. [Abstract] [Full Text]
|
|
|
|
|
|
M. Rubino, S. V. Praagh, K. Kadoba, R. Pessotto, and R. V. Praagh Systemic and pulmonary venous connections in visceral heterotaxy with asplenia: Diagnostic and surgical considerations based on seventy-two autopsied cases J. Thorac. Cardiovasc. Surg., September 1, 1995; 110(3): 641 - 650. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
