Embolic stroke in a postpartum patient with Fontan physiology

VanHise, Katherine; Li, Linda; Smith, Emily; Condon, Niamh

doi:10.1136/bcr-2017-222684

Cited by 5 publications

(6 citation statements)

References 17 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mechanism by which the patient's age affects mortality is related to cardiovascular anatomy and pulmonary vascular structure reactivity that have not completed their development [9]. Among the causes of mortality in patients who have undergone Fontan surgery, arrhythmia, thromboembolism, cerebrovascular events and systemic venous return tract narrowing are also included [10]. As we know, there are 2 types of Fontan surgery as lateral tunnel and extra cardiac type.…”

Section: Discussionmentioning

confidence: 99%

Fontan Operation Experience and Results of our Cardiovascular Surgery Center

Gojayev¹,

Cholak²,

Tireli³

2023

J Surg Open Access

View full text Add to dashboard Cite

Introduction: In this study, we present our experiences and results of the first Fontan surgeries we performed in our center in accordance with the surgical criteria we believe in. Materials and methods: This is an observational study involving 19 patients. We investigated the data and survival rate of 19 patients who underwent Fontan surgery one by one. We wanted to know how the surgical method we used and the age factor affected our results. Our main hypothesis was to keep the cardiopulmonary bypass time very short and not to prefer the total circulatory arrest method. Results: Patients were not homogeneous in terms of demographic characteristics. Patients differed in terms of pre- and postoperative cardiac diagnosis and complications. We lost 2 of 19 patients and the overall mortality rate was 10.5%. We used Extracardiac Membrane Oxygenation (ECMO) support in 3 patients. We applied Implantable Cardioverter Defibrillator (ICD) implantation to the patient. The discharge due to effusion due to chylothorax was prolonged in 4 patients. The postoperative NHYA capacity of the patients was evaluated as 1 or 2. Discussion: We recommend that this operation should not be performed at a very young age, if the oxygen saturation value of heart patients who are candidates for Fontan is not very critical, if the ventricular ejection fraction capacity is not low, if the physical exertion capacity and examination findings are within normal limits. Conclusion: The Fontan procedure is still the best long-term palliative operation for all single ventricle cases. We believe that it would be beneficial to postpone this surgery to the advanced age group as much as possible in order not to increase the mortality rate.

show abstract

Section: Discussionmentioning

confidence: 99%

Fontan Operation Experience and Results of our Cardiovascular Surgery Center

Gojayev¹,

Cholak²,

Tireli³

2023

J Surg Open Access

View full text Add to dashboard Cite

show abstract

“…The mechanism by which the patient's age affects mortality is related to cardiovascular anatomy and pulmonary vascular structure reactivity that have not completed their development (5). Among the causes of mortality in patients who have undergone Fontan surgery, arrhythmia, thromboembolism, cerebrovascular events and systemic venous return tract narrowing are also included (6). As we know, there are 2 types of Fontan surgery as lateral tunnel and extra cardiac type.…”

Section: Discussionmentioning

confidence: 99%

Fontan operation experience and results of our cardiovascular surgery center

Gojayev

Tirelı

2022

Preprint

View full text Add to dashboard Cite

Objective: In this study, we present our experiences and results of the first Fontan surgeries we performed in our center in accordance with the surgical criteria we believe in.Materials and methods: This is an observational study involving 19 patients. We performed Fontan surgery on these patients in the 2018-2020 period. There were 11 men and 8 women among the patients. We preferred the extracardiac tunnel method in all cases. We did not prefer total circulatory arrest during cardiopulmonary bypass in any case.Results: Patients were not homogeneous in terms of demographic characteristics. Patients differed in terms of pre- and postoperative cardiac diagnosis and complications. We lost 2 of 19 patients and the overall mortality rate was 10.5%. We used extracardiac membrane oxygenation (ECMO) support in 3 patients. We applied ICD implantation to the patient. The discharge due to effusion due to chylothorax was prolonged in 4 patients. The postoperative NHYA capacity of the patients was evaluated as 1 or 2.Conclusion: If the oxygen saturation value of Fontan candidate heart patients is not critical, if the ventricular functionality is at normal capacity, if the effort capacity, hemodynamic stability and physical examination findings are close to normal, we recommend that this operation not be performed at very young ages. We believe that it would be beneficial to postpone this surgery to the advanced age group as much as possible in order not to increase the mortality rate.

show abstract

“…While available evidence suggests that antiplatelet agents alone may prove as effective as oral anticoagulants in primary prevention, anticoagulant therapy is generally preferred over the first 6 months following Fontan surgery, as well as in the case of previous thromboembolic events (secondary prevention). 15,16 TJLB is usually performed as an inpatient procedure and the patient sedated. ECG, blood pressure, and pulse oximetry are monitored throughout the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the high risk of thromboembolism in Fontan patients caused by slow blood flow and conduit insertion, antiaggregant or anticoagulant therapies are routinely prescribed. While available evidence suggests that antiplatelet agents alone may prove as effective as oral anticoagulants in primary prevention, anticoagulant therapy is generally preferred over the first 6 months following Fontan surgery, as well as in the case of previous thromboembolic events (secondary prevention) 15,16 . TJLB is usually performed as an inpatient procedure and the patient sedated.…”

Section: Discussionmentioning

confidence: 99%