Functional outcome after the Fontan operation: Factors influencing late morbidity

Gentles, Thomas L.; Gauvreau, Kimberlee; Mayer, John E.; Fishberger, Steven B.; Burnetta, Janice; Colan, Steven D.; Newburger, Jane W.; Wernovsky, Gil

doi:10.1016/s0022-5223(97)70184-3

Cited by 199 publications

(145 citation statements)

References 18 publications

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“…Although the immediate mortality in this series was higher than that reported in the literature 1,[10][11][12][13]16,17 , the late mortality in our group of patients was similar to that found by other authors 15,19 underwent the right atrium-pulmonary artery or Björk techniques, and found a survival rate of 15 years in about 70%, for both techniques. In our group of patients, a high mortality occurred in the immediate postoperative period.…”

Section: Discussionsupporting

confidence: 88%

“…Our patients were operated on, on the average, at about 5 years of age, as with other groups 16,19,20 ; they had a tendency toward being younger during the last decade of our experience, like in the Toronto 15 and Boston 17 groups. Older age at surgery is a risk factor of late mortality after the Fontan operation, because the prolonged volume overload in the working ventricle and persistent cyanosis contribute to the progressive deterioration of the cardiac muscle 1,19 , although Yeh et al 15 were unable to prove a significant increase in survival by anticipating the moment of surgery.…”

Section: Discussionmentioning

confidence: 70%

“…In this study, we evaluated 25 patients with tricuspid atresia and an average follow-up of about 5 years after Fontan surgery or its variants, similar to that reported by other authors 15,16,19 . Our patients were operated on, on the average, at about 5 years of age, as with other groups 16,19,20 ; they had a tendency toward being younger during the last decade of our experience, like in the Toronto 15 and Boston 17 groups.…”

Section: Discussionmentioning

confidence: 90%

“…On the last check-up, most (67%) of the patients were asymptomatic, and 87% tolerated exercise, based on direct patient questioning (a method resembling that used by Gentles et al 16 …”

Section: Resultsmentioning

confidence: 99%

“…Basically, a communication is established between the systemic venous return and the pulmonary arterial circulation, bypassing the right ventricle flow 2,3 . As years went by, however, a number of changes were proposed to the classical Fontan operation, such as the Kreutzer technique 4 , the Björk technique 5 , and the total cavopulmonary shunt (TCPC) [6][7][8][9] , and very few studies deal with the long-term follow-up of patients who undergo these procedures [10][11][12][13][14][15][16][17][18] .Considering that Fontan surgery is a relatively recent therapeutic procedure and that, in addition to this, some important changes were added to the original surgical technique, this study aims at evaluating late survival, as well as the complications that occurred during the long-term follow-up of patients with tricuspid atresia who underwent Fontan surgery or its variants. …”

mentioning

confidence: 99%

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Late Clinical Outcomes of the Fontan Operation in Patients with Tricuspid Atresia

Mastalir

Kalil

Horowitz

et al. 2002

Arq. Bras. Cardiol.

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Objective -Evaluation of the long-term clinical results of the Fontan operation in patients with tricuspid atresia. Methods -A retrospective analysis was made at the Instituto de Cardiologia do Rio Grande do Sul (Institute of Cardiology of Rio Grande do Sul), from August 1980 throughTricuspid atresia is a rare cardiac malformation, in which no communication exists between the right atrium and the right ventricle, bringing about complex physiological adaptations and culminating with high morbidity and mortality, thus requiring the utilization of an adequate surgical technique for its correction 1 . So, in 1971, Fontan and Baudet 2 introduced the basis for an operation that became the final palliative surgery for patients with tricuspid atresia. Basically, a communication is established between the systemic venous return and the pulmonary arterial circulation, bypassing the right ventricle flow 2,3 . As years went by, however, a number of changes were proposed to the classical Fontan operation, such as the Kreutzer technique 4 , the Björk technique 5 , and the total cavopulmonary shunt (TCPC) [6][7][8][9] , and very few studies deal with the long-term follow-up of patients who undergo these procedures [10][11][12][13][14][15][16][17][18] .Considering that Fontan surgery is a relatively recent therapeutic procedure and that, in addition to this, some important changes were added to the original surgical technique, this study aims at evaluating late survival, as well as the complications that occurred during the long-term follow-up of patients with tricuspid atresia who underwent Fontan surgery or its variants.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 90%

“…On the last check-up, most (67%) of the patients were asymptomatic, and 87% tolerated exercise, based on direct patient questioning (a method resembling that used by Gentles et al 16 …”

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Late Clinical Outcomes of the Fontan Operation in Patients with Tricuspid Atresia

Mastalir

Kalil

Horowitz

et al. 2002

Arq. Bras. Cardiol.

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The Paradigm Shift Toward Surgical Intervention for Neonates With Hypoplastic Left Heart Syndrome

Wernovsky¹

2008

Arch Pediatr Adolesc Med

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Cardiac Intensive Care

Jeremias¹,

Brown²

2005

Anesthesia for Congenital Heart Disease

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The specialty of pediatric cardiac critical care has undergone rapid scientific and clinical growth in the last 25 years. The Board of Directors of the Pediatric Cardiac Intensive Care Society assembled an updated list of sentinel references focused on the critical care of children with congenital and acquired heart disease. We encouraged board members to select articles that have influenced and informed their current practice or helped to establish the standard of care. The objective of this article is to provide clinicians with a compilation and brief summary of these updated 100 useful references. Data Sources: The list of "One Hundred Useful References for Pediatric Cardiac Intensive Care" ( 2004) and relevant literature to the practice of cardiac intensive care. Data Selection: A subset of Pediatric Cardiac Intensive Care Society board members compiled the initial list of useful references in 2004, which served as the basis of the new updated list. Suggestions for relevant articles were submitted by the Pediatric Cardiac Intensive Care Society board members and selected pediatric cardiac intensivists with an interest in this project following the Society's meeting in 2010. Articles were considered for inclusion if they were named in the original list from 2004 or were suggested by Pediatric Cardiac Intensive Care Society board members and published before December 31, 2011. Data Extraction: Following submission of the complete list by the Pediatric Cardiac Intensive Care Society board and contributing Society members, articles were complied by the two co-first authors (D.A., D.K.). The authors also performed Medline searches to ensure comprehensive inclusion of all relevant articles. The final list was then submitted to the Pediatric Cardiac Intensive Care Society board members, who ranked each publication. Data Synthesis: Rankings were compiled and the top 100 articles with the highest scores were selected for inclusion in this publication. The two co-first authors (D.A., D.K.) reviewed all existing summaries and developed summaries of the newly submitted articles.Conclusions: An updated compilation of 100 useful references for the critical care of children with congenital and acquired heart disease has been compiled and summarized here. Clinicians and trainees may wish to use this document as a reference for education in this complex and challenging subspecialty. (Pediatr Crit Care Med 2013; 14:770-785)

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Functional outcome after the Fontan operation: Factors influencing late morbidity

Abstract: A poor functional outcome is uncommon after the Fontan operation but becomes more frequent with increasing duration of follow-up.

Cited by 199 publications

References 18 publications

Late Clinical Outcomes of the Fontan Operation in Patients with Tricuspid Atresia

Late Clinical Outcomes of the Fontan Operation in Patients with Tricuspid Atresia

The Paradigm Shift Toward Surgical Intervention for Neonates With Hypoplastic Left Heart Syndrome

Cardiac Intensive Care

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