Document Detail

The fenestrated Fontan procedure.
MedLine Citation:
PMID:  1383113     Owner:  NLM     Status:  MEDLINE    
In 90 patients with characteristics placing them at increased risk for a Fontan operation, a fenestration was created in the atrial baffle at the time of the Fontan repair. The rational was to allow a right to left shunt which would maintain cardiac output and limit right atrial pressure in the presence of conditions which limit pulmonary blood flow. Early mortality was 4/90 (4%), with an additional two patients having the Fontan repair taken down to a bidirectional cavopulmonary anastomosis. Postoperative right atrial pressures were low (average 13 mm Hg), as was the incidence of prolonged pleural effusions (13%). At short-term (average 13 months) follow-up, 77% of patients have had closure of the fenestration, and 92% are in New York Heart Association Class I. We conclude that baffle fenestration with subsequent transcatheter closure results in decreased mortality and morbidity among high risk patients undergoing a Fontan repair, and that the high functional level at short-term follow-up justifies continued aggressive management of such patients.
N D Bridges; A R Castaneda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Herz     Volume:  17     ISSN:  0340-9937     ISO Abbreviation:  Herz     Publication Date:  1992 Aug 
Date Detail:
Created Date:  1992-11-06     Completed Date:  1992-11-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7801231     Medline TA:  Herz     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  242-5     Citation Subset:  IM    
Department of Cardiology, Children's Hospital, Boston.
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MeSH Terms
Cardiac Output, Low / diagnosis,  physiopathology*
Child, Preschool
Heart Atria / physiopathology,  surgery*
Heart Catheterization
Heart Defects, Congenital / physiopathology,  surgery*
Heart Septum / physiopathology,  surgery
Oxygen / blood
Palliative Care / methods*
Postoperative Complications / diagnosis,  physiopathology*
Reg. No./Substance:

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