Document Detail


Compression of an extracardiac fontan following classic fontan revision.
MedLine Citation:
PMID:  15151656     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The extracardiac Fontan arose as an alternative in order to prevent the classical procedure's sequelea. Complications of the extracardiac Fontan have been described, but this case report aims to highlight the devastating and infrequent complication of external conduit compression. METHODS AND RESULTS: A 25-year-old male underwent Fontan conversion to extracardiac Fontan for atrial arrhythmias and giant right atrium. He developed postoperative respiratory distress, renal failure, and hemorrhagic pancreatitis, which prompted CT scans of his chest and abdomen that demonstrated external compression of the conduit by mediastinal hematoma. Endovascular stenting restored flow through the conduit, but the patient ultimately expired. CONCLUSIONS: External Fontan compression, which can be caused by numerous sources, may lead to significant organ dysfunction and can be difficult to recognize despite invasive monitoring. We report this complication and suggest ringed conduits to be considered to avoid the possibility of external compression.
Authors:
Jefferson M Lyons; Jodie Y Duffy; Peter B Manning; Jeffrey M Pearl
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  19     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2004 May-Jun
Date Detail:
Created Date:  2004-05-20     Completed Date:  2004-11-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  254-7     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Echocardiography, Transesophageal
Fontan Procedure / adverse effects*
Heart Atria / pathology,  surgery
Heart Ventricles / pathology,  surgery
Hematoma / diagnosis,  etiology,  mortality
Hemothorax / diagnosis,  etiology,  mortality
Humans
Male
Pancreatitis, Acute Necrotizing / diagnosis,  etiology,  mortality
Postoperative Complications / diagnosis,  etiology,  mortality
Tachycardia, Ectopic Atrial / diagnosis,  surgery
Tomography, X-Ray Computed
Treatment Failure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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