Document Detail

Transition of ventricular function and energy efficiency after a primary or staged Fontan procedure.
MedLine Citation:
PMID:  18854926     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The transitional changes of the ventricular function at different time points after total cavopulmonary connection (TCPC) were examined. METHODS: A total of 29 patients were divided into a primary TCPC group and a staged TCPC group. In both groups, phase I was defined as within 2 months after TCPC and phase II as beyond at least a year after TCPC. Changes in ventricular end-diastolic volume (EDV), ventricular end-systolic elastance (Ees), effective arterial elastance (Ea), and ventriculoarterial coupling (Ea/Ees) were evaluated. RESULTS: The results for the primary TCPC group are as follows. Phase I: The EDV decreased (P < 0.05). The Ees and Ea both increased (P < 0.05). Ea/Ees showed a tendency to increase (P = 0.08). Phase II: The EDV decreased (P < 0.05). The Ees increased significantly, and Ea showed no significant change. Ees/Ea showed a tendency to decrease (P = 0.07). The results for the staged TCPC group were as follows. Phase I: The EDV decreased significantly after bidirectional cavopulmonary shunt (BCPS). The Ees showed no significant change after BCPS and TCPC. Although Ea increased after BCPS (P < 0.05), it showed no significant change after TCPC. Ea/Ees showed no significant change. Phase II: The Ees increased (P < 0.05) without significant changes of EDV and Ea. As a result, Ea/Ees showed a tendency to decrease. CONCLUSION: This study suggested improved ventricular function in both groups. These results suggest hemodynamic adaptation to the Fontan circulation. The deleterious effects on ventricular function caused by the Fontan procedure disappeared within a couple of years. This acute effect can be ameliorated by the staged approach to the Fontan circulation.
Manabu Watanabe; Mitsuru Aoki; Tadashi Fujiwara
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Publication Detail:
Type:  Journal Article     Date:  2008-10-15
Journal Detail:
Title:  General thoracic and cardiovascular surgery     Volume:  56     ISSN:  1863-6705     ISO Abbreviation:  -     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-15     Completed Date:  2008-12-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101303952     Medline TA:  Gen Thorac Cardiovasc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  498-504     Citation Subset:  IM    
Unit of Cardiovascular Surgery, Hokkaido Medical Center for Child Health and Rehabilitation, 1-1 Kanayama, Teine-ku, Sapporo, Hokkaido, 006-0041, Japan.
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MeSH Terms
Child, Preschool
Fontan Procedure* / adverse effects
Heart Defects, Congenital / physiopathology,  surgery*
Recovery of Function
Retrospective Studies
Time Factors
Treatment Outcome
Ventricular Function*

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