| Clinical outcomes of Fontan conversion surgery with and without associated arrhythmia intervention. | |
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MedLine Citation:
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PMID: 18706713 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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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. |
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Authors:
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Kazuhiro Takahashi; Francis Fynn-Thompson; Frank Cecchin; Paul Khairy; Pedro del Nido; John K Triedman |
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Publication Detail:
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Type: Journal Article Date: 2008-08-15 |
Journal Detail:
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Title: International journal of cardiology Volume: 137 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-12-07 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 260-6 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Children's Hospital Boston, Boston, MA 02115, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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