| The Fontan/Kreutzer procedure at 40: an operation for the correction of tricuspid atresia. | |
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MedLine Citation:
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PMID: 20307868 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The first atriopulmonary anastomosis (APA) with neither a valve in the inferior vena cava (IVC) nor an Glenn shunt was performed in 1971. A fenestration was intentionally left in the atrial septum. In a second patient, the APA incorporated the patient's own pulmonary valve, which had been removed from the outflow tract of the right ventricle. Since the early days, our rationale was that the right atrium would only function as a pathway, and the end diastolic pressure and the systole of the main ventricle would be the principal "pump" of this system. The late hemodynamic problems of the APA have decreased with newer and better surgical techniques, such as the lateral tunnel (LT) or the extracardiac conduit (EC). Although these procedures have improved the prognosis and quality of life of patients with a univentricular heart (UH), in the long run, deterioration frequently occurs because of chronic low cardiac output and high central venous pressure. Progressive increase in pulmonary vascular resistances and ventricular dysfunction are frequently the underlying reasons for this deterioration. However, such deterioration is not inevitable in every case, as shown in the longest survivor of the world after 34 years of follow-up. The Fontan Kreutzer (FK) palliation represents the best surgical option despite its uncertain late outcome. Certainly, it is one of the triumphs of cardiac surgery in congenital heart disease. |
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Authors:
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Guillermo O Kreutzer; Andrés J Schlichter; Christian Kreutzer |
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Publication Detail:
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Type: Historical Article; Journal Article |
Journal Detail:
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Title: Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual Volume: 13 ISSN: 1092-9126 ISO Abbreviation: Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu Publication Date: 2010 |
Date Detail:
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Created Date: 2010-03-23 Completed Date: 2010-07-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9815944 Medline TA: Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu Country: United States |
Other Details:
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Languages: eng Pagination: 84-90 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Cardiovascular Surgery, Hospital de Niños and Clínica Bazterrica, Buenos Aires, Argentina. gokreutzer@arnet.com.ar |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Fontan Procedure
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history*,
methods History, 20th Century Humans Tricuspid Atresia / history*, physiopathology, surgery |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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