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Functional Capacity Following Univentricular Repair-Midterm Outcome.
MedLine Citation:
PMID:  22471644     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective.  Previous studies have seldom compared functional capacity in children following Fontan procedure alongside those with Glenn operation as destination therapy. We hypothesized that Fontan circulation enables better midterm submaximal exercise capacity as compared to Glenn physiology and evaluated this using the 6-minute walk test. Design and Patients.  Fifty-seven children aged 5-18 years with Glenn (44) or Fontan (13) operations were evaluated with standard 6-minute walk protocols. Results.  Baseline SpO(2) was significantly lower in Glenn patients younger than 10 years compared to Fontan counterparts and similar in the two groups in older children. Postexercise SpO(2) fell significantly in Glenn patients compared to the Fontan group. There was no statistically significant difference in baseline, postexercise, or postrecovery heart rates (HRs), or 6-minute walk distances in the two groups. Multiple regression analysis revealed lower resting HR, higher resting SpO(2) , and younger age at latest operation to be significant determinants of longer 6-minute walk distance. Multiple regression analysis also established that younger age at operation, higher resting SpO(2) , Fontan operation, lower resting HR, and lower postexercise HR were significant determinants of higher postexercise SpO(2) . Younger age at operation and exercise, lower resting HR and postexercise HR, higher resting SpO(2) and postexercise SpO(2) , and dominant ventricular morphology being left ventricular or indeterminate/mixed had significant association with better 6-minute work on multiple regression analysis. Lower resting HR had linear association with longer 6-minute walk distances in the Glenn patients. Conclusions.  Compared to Glenn physiology, Fontan operation did not have better submaximal exercise capacity assessed by walk distance or work on multiple regression analysis. Lower resting HR, higher resting SpO(2) , and younger age at operation were factors uniformly associated with better submaximal exercise capacity.
Authors:
Supratim Sen; Biswajit Bandyopadhyay; Peter Eriksson; Amitabha Chattopadhyay
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-3
Journal Detail:
Title:  Congenital heart disease     Volume:  -     ISSN:  1747-0803     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Wiley Periodicals, Inc.
Affiliation:
Department of Pediatric Cardiology, RN Tagore International Institute of Cardiac Sciences, Kolkata, India Sahlgrenska University Hospital, GUCH Center Goteborg, Sweden.
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