| Modified Fontan procedure for biventricular hearts with complex forms of double-outlet right ventricle. | |
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MedLine Citation:
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PMID: 3180399 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The surgical management of patients with biventricular hearts and complex double-outlet right ventricle with noncommitted ventricular septal defect, hypoplastic ventricles, common atrioventricular orifice, straddling tricuspid valve, and straddling mitral valves is controversial. More recently at our institution, 23 of these patients underwent Fontan-type procedures as an alternative to the intraventricular tunnel repair. In all cases, the presence of more than one associated anomaly would have prevented adequate biventricular correction. The ventricular septal defects were of the inlet type in 14 patients, inlet and subpulmonary in one, multiple in one, subpulmonary in three, and subaortic in four. Twenty-one patients had atrioventricular junction anomalies, and 14 had hypoplastic ventricles (left ventricle in 11 and right ventricle in three). Pulmonary stenosis was present in 13 patients and pulmonary atresia in two. At operation, an extracardiac conduit was used in two patients and an atriopulmonary direct anastomosis in 21. There were six hospital deaths (26%). Seventeen patients had a mean follow-up period of 25 months. At the follow-up evaluation, nine patients were assigned to New York Heart Association Class I and seven to Class II; one patient assigned to Class IV died at 9 months postoperatively. Cumulative mortality was 30.4% (seven deaths). Univariate analysis identified hypoplastic left ventricle with any type of ventricular septal defect and atrioventricular junction as the only incremental risk factor for early and late outcome (p less than 0.01), which also influenced functional status and use of drug therapy (p less than 0.01) at the time of follow-up.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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P Russo; G K Danielson; F J Puga; D C McGoon; R Humes |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Circulation Volume: 78 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1988 Nov |
Date Detail:
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Created Date: 1988-12-15 Completed Date: 1988-12-15 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: III20-5 Citation Subset: AIM; IM |
Affiliation:
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Section of Cardiothoracic Surgery, Mayo Clinic, Rochester, Minnesota. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Cardiovascular System / physiopathology Child Child, Preschool Double Outlet Right Ventricle / classification, physiopathology, surgery* Female Follow-Up Studies Humans Length of Stay Male Postoperative Complications / mortality Postoperative Period Reoperation Risk Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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