|Impact of age at Fontan completion on postoperative hemodynamics and long-term aerobic exercise capacity in patients with dominant left ventricle.|
|PMID: 19161779 Owner: NLM Status: MEDLINE|
|BACKGROUND: Although the Fontan procedure is now being applied to younger patients, the influence of patients' age at the time of surgery on long-term results remains unclear. We investigated whether age at Fontan completion affects subsequent hemodynamics and exercise capacity in patients with a dominant left ventricle followed up for more than 5 years. METHODS: Between January 1990 and December 2001, 68 patients with a dominant left ventricle underwent total cavopulmonary connection (TCPC) at our institute. The survivors routinely underwent postoperative exercise tests and catheterization at 1 year and then every 5 years after TCPC, and were divided into group A (< 3 years; n = 32) and group B (> or = 3 years; n = 33), according to age at time of the Fontan procedure and retrospectively reviewed. We also examined the correlation between age at Fontan and data from postoperative catheterization or exercise tests. RESULTS: None of the patients died during a follow-up period of 91.2 +/- 46.7 months. The postoperative exercise capacity (peak oxygen consumption; % of normal [61.3 +/- 11.5 versus 51.9 +/- 9.1, p = 0.0001]), cardiac index at 5 years (3.31 +/- 0.62 versus 2.86 +/- 0.69, p = 0.0133) and at 10 years after TCPC (3.24 +/- 0.46 versus 2.61 +/- 0.65, p = 0.0194), and ventricular ejection fraction (%) at 10 years after TCPC (62.1 +/- 7.6 versus 53.0 +/- 8.0, p = 0.0131) were significantly higher in group A. Age at Fontan completion inversely correlated with postoperative peak oxygen consumption (R = -0.374, p = 0.0006) and cardiac index at 5 years (R = -0.452, p = 0.0003) and 10 years after TCPC (R = -0.491, p = 0.0072). CONCLUSIONS: Earlier TCPC is beneficial in the long term from the viewpoint of exercise capacity and hemodynamics among patients with a dominant left ventricle.|
|Shuichi Shiraishi; Toshikatsu Yagihara; Koji Kagisaki; Ikuo Hagino; Hideo Ohuchi; Junjiro Kobayashi; Soichiro Kitamura|
Related Documents :
|9715859 - Adverse events with transvenous implantable cardioverter-defibrillators: a prospective ...
18304129 - Bovine valved xenograft (contegra) conduit in the extracardiac fontan procedure: the pr...
18640339 - Results of definitive repair of complete atrioventricular septal defect in neonates and...
20206539 - Fontan completion rate and outcomes after bidirectional cavo-pulmonary shunt.
18391109 - Percutaneous pulmonary valve implantation: impact of evolving technology and learning c...
8820829 - The 'modern' implantable cardioverter-defibrillator: comparing it to those of the late ...
17161089 - Immediate laparoscopic cholecystectomy for acute cholecystitis: no need to wait.
24259659 - Early pharmacological treatment of delirium may reduce physical restraint use: a retros...
15664879 - Intra-articular hylan g-f 20 (synvisc) in the management of patellofemoral osteoarthrit...
|Type: Comparative Study; Journal Article|
|Title: The Annals of thoracic surgery Volume: 87 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2009 Feb|
|Created Date: 2009-01-23 Completed Date: 2009-02-11 Revised Date: 2010-01-28|
Medline Journal Info:
|Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands|
|Languages: eng Pagination: 555-60; discussion 560-1 Citation Subset: AIM; IM|
|Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.|
|APA/MLA Format Download EndNote Download BibTex|
Exercise Tolerance / physiology*
Fontan Procedure / methods*, mortality
Heart Defects, Congenital / diagnosis, mortality, surgery
Heart Ventricles / abnormalities*
Hemodynamics / physiology*
Oxygen Consumption / physiology
Postoperative Care / methods
Tricuspid Atresia / mortality, surgery*
|Ann Thorac Surg. 2010 Feb;89(2):675-6
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Inclusion of hepatic venous drainage in patients with pulmonary arteriovenous fistulas.
Next Document: Midterm to long-term outcome of total cavopulmonary connection in high-risk adult candidates.