Document Detail


Clinical outcomes of Fontan conversion surgery with and without associated arrhythmia intervention.
MedLine Citation:
PMID:  18706713     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To characterize mortality and morbidity outcomes in patients undergoing surgical Fontan conversion. BACKGROUND: Indications for and anticipated clinical outcomes associated with Fontan conversion are controversial. METHODS: A retrospective single-center cohort study of consecutive patients undergoing Fontan conversion between 1990 and 2006 stratified according to concomitant arrhythmia surgery. RESULTS: Forty patients underwent Fontan conversion at a median age of 19.0 years and were followed for 4.2 years. Six (15%) died, two perioperatively, three early postoperatively, and one following heart transplant. Older age was a univariate risk factor. Major perioperative complications occurred in 9 of 35 (26%) early survivors. Patients with concomitant arrhythmia surgery (N=21) were older at conversion and had longer interoperative intervals. They experienced a reduction in prevalence (95% vs. 28%, P<0.0001) and severity (severity score 7.3 vs. 3.3, P=0.001) of atrial tachyarrhythmias, in contrast to patients without arrhythmia surgery (47% vs. 53%; 3.3 vs. 3.9, P=NS). NYHA functional class improved in both groups. In a subgroup (N=14) with non-urgent late postoperative catheterization, filling pressures were unchanged from preoperative values. CONCLUSIONS: Mortality and morbidity after Fontan conversion are substantial, but survivors experience a subjective improvement in functional status. Concomitant arrhythmia surgery reduces the arrhythmia burden without a detectable increase in complication rates.
Authors:
Kazuhiro Takahashi; Francis Fynn-Thompson; Frank Cecchin; Paul Khairy; Pedro del Nido; John K Triedman
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Publication Detail:
Type:  Journal Article     Date:  2008-08-15
Journal Detail:
Title:  International journal of cardiology     Volume:  137     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-12-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  260-6     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Children's Hospital Boston, Boston, MA 02115, USA.
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