Left ventricular function after a Fontan operation in patients with pulmonary atresia with an intact ventricular septum

Abstract

Compared to patients with PA/IVS without SC, patients with PA/IVS with SC had a low cardiac contractility and decreased cardiac output efficiency after the Fontan procedure.

Stratification of the right ventricle–dependent coronary circulation: Relevance to treatment strategy

“…Historically, the number of affected coronary artery distributions has been reported, and some authors have incorporated a minimum number of distributions into the definition of RV-dependent coronary circulation. [1][2][3][6][7][8] Although both measures likely provide important information on the volume of vulnerable myocardium, we hold that the location of coronary artery atresia is likely a better indicator of myocardium at risk than a gross number of major coronary artery distributions involved. In defining location of coronary artery atresia, we use the SYNTAX score criteria; thus, proximal atresia includes ostial atresia, atresia of the left main coronary artery, left anterior descending artery to the take-off septal branch, left circumflex to the take-off of the first obtuse marginal branch, or right coronary artery proximal to one-half the distance to the acute margin (Figure 3).…”

“…Considerable controversy exists over whether 2 affected major coronary artery distributions are required to meet the diagnosis [1][2][3][6][7][8] or if single distribution involvement is sufficient. 4,[9][10][11] The premise remains that a sufficient threshold of myocardium dependent on a pressurized RV to maintain coronary perfusion obligates single ventricle palliation or cardiac transplantation.…”