Document Detail


Outcome and assessment after the modified Fontan procedure for hypoplastic left heart syndrome.
MedLine Citation:
PMID:  1728440     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We reviewed the outcome of 76 consecutive patients (age range, 5 months to 6 years; median age, 19 months) who underwent a modified Fontan procedure after initial palliative surgery for hypoplastic left heart syndrome (HLHS) between January 1984 and December 1989. METHODS AND RESULTS: Modifications of the Fontan procedure included transatrial baffle of pulmonary venous return to the tricuspid valve (n = 10) or inferior vena cava baffle within the right atrium to the superior vena caval-pulmonary artery anastomosis, with pulmonary artery augmentation (n = 66). Actuarial survival rates were 74% (1 month), 58% (12 months), 56% (2 years), and 52% (4 years). Of the 43 survivors, 25 patients have returned for postoperative cardiac catheterization at a medium of 13 months after the Fontan procedure. Mean +/- SD hemodynamic values were cardiac index, 2.8 +/- 0.6 l/min/m2; right arterial pressure, 11 +/- 2 mm Hg; pulmonary artery wedge pressure, 6 +/- 3 mm Hg; and arterial oxygen saturation, 94 +/- 3%. No patient had significant tricuspid or native pulmonary valve insufficiency. CONCLUSIONS: Survival after the Fontan procedure in patients with HLHS is comparable to survival after a Fontan procedure in patients with other complex congenital heart lesions. In the subgroup of patients with HLHS who survived both reconstructive surgery and a Fontan procedure and have been evaluated by cardiac catheterization after a Fontan procedure, the use of the right ventricle as the systemic ventricle yielded excellent intermediate results for Fontan physiology.
Authors:
P E Farrell; A C Chang; K A Murdison; J M Baffa; W I Norwood; J D Murphy
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  85     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1992 Jan 
Date Detail:
Created Date:  1992-02-06     Completed Date:  1992-02-06     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  116-22     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Children's Hospital of Philadelphia, PA 19104.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures / methods*
Child
Child, Preschool
Coronary Angiography
Female
Follow-Up Studies
Heart Catheterization
Heart Defects, Congenital / diagnosis,  mortality,  surgery*
Humans
Infant
Male
Postoperative Period
Survival Analysis
Comments/Corrections
Comment In:
Circulation. 1992 Jan;85(1):372-3   [PMID:  1728472 ]
Circulation. 1992 Nov;86(5):1662   [PMID:  1385007 ]

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


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