Cardiac Resynchronization Therapy for the Failing Fontan Patient

Soják, Vladimír; Mazić, Uroš; Cesen, Maja; Schrader, Jürgen; Danojević, Nenad

doi:10.1016/j.athoracsur.2007.12.010

Cited by 31 publications

(11 citation statements)

References 3 publications

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“…In addition, resynchronization therapy using multisite pacing has been shown to be effective in univentricular hearts with prolonged QRS durations and dysynchronous ventricular contraction [11,17,19,33,34]. Although it may be impossible to predict the manner of dysynchrony at Fontan surgery, which would require epicardial leads later, we are aware of the development of an epicardial pacemaker multilead array incorporated into a cardiac harness, which could be placed at Fontan surgery and used, when appropriate, at a later date [8].…”

mentioning

confidence: 99%

Fontan “Ten Commandments” Revisited and Revised

Stern

2010

Pediatr Cardiol

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Choussat's ''Ten Commandments,'' which describes the components of an ideal Fontan candidate, was first published in 1977. Despite the wisdom in these commandments, it is clear from a historic perspective that total compliance with all criteria does not necessarily portend excellent long-term survival. I believe the end point of the original commandments should be modified to include improvement in long-term survival. I suggest the following single commandment: ''Thou Shalt Be Perfect.''

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confidence: 99%

Fontan “Ten Commandments” Revisited and Revised

Stern

2010

Pediatr Cardiol

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“…In addition, little evidence is available for the use of cardiac resynchronization therapy 15 or implantable cardioverter-defibrillators (ICDs) in patients who have undergone the Fontan procedure. As a result of lack of access from the systemic venous system into the heart with all types of Fontans except the AV Fontan unless a fenestration is present, the leads for cardiac resynchronization therapy and ICDs need to be placed on the epicardium.…”

Section: Single-ventricle Circulationmentioning

confidence: 99%

Long-term Issues After the Fontan Procedure

McRae

2013

AACN Advanced Critical Care

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The Fontan procedure is used to treat various serious congenital heart defects. Although many people who have had the procedure live productively into adulthood, as they age, they face several health issues due to the physiology of the Fontan circulation. This article reviews the 4 types of Fontan procedures and the changes caused by the surgery, including single-ventricle physiology, nonpulsatile pulmonary perfusion, systemic venous hypertension, and intracardiac scarring, as well as their sequelae. Key nursing assessment items and possible treatment strategies are reviewed. Additional topics, including pregnancy in patients who have undergone the procedure, infective endocarditis prophylaxis, and health-related quality of life, are briefly discussed. Options for Fontan failure, including Fontan conversion or transplantation, are presented. Potential future solutions are outlined.

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“…This may be in the setting of a single RV or LV, a systemic RV or DCM in patients with otherwise normal hearts. Early CRT, offered before there is a critical decrease in ventricular function, may be able to stop that inevitable process [38][39][40][41][42][43]. Future research directed at delineating the optimal time to offer resynchronization therapy and algorithms to minimize the deleterious effects of more traditional ventricular pacing are needed.…”

Section: Adults With Congenital Heart Diseasementioning

confidence: 99%

Pacing treatment for dilated cardiomyopathy: optimization of resynchronization pacing in pediatrics

Greene

Berul

2010

Current Opinion in Cardiology

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CRT is becoming a valuable tool in the treatment of ventricular dyssynchrony and dilated cardiomyopathy in pediatric and congenital heart disease patients. Diagnostic advances in electrophysiology and echocardiography have enabled clinicians to more effectively evaluate, treat, and optimize device programming for patients before and after CRT. These modalities also allow more detailed data collection, which may aid in the refinement of indications and impact of CRT in this unique population.

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Cardiac Resynchronization Therapy for the Failing Fontan Patient

Cited by 31 publications

References 3 publications

Fontan “Ten Commandments” Revisited and Revised

Fontan “Ten Commandments” Revisited and Revised

Long-term Issues After the Fontan Procedure

Pacing treatment for dilated cardiomyopathy: optimization of resynchronization pacing in pediatrics

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