Hemodynamic Changes and Clinical Outcomes after the Intra/Extracardiac Fenestrated Fontan Procedure

Menon, Naveen; Lin, Chih-Yang; Mesia, Cesar I.; Moulick, Achintya; Stevens, Randy; Mahan, Vicki

doi:10.4236/wjcs.2018.82004

Cited by 2 publications

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References 23 publications

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“…All patients undergo a diagnostic cardiac catheterization 12 months after the procedure to assess changes in hemodynamics. In a retrospective review of 14 patients undergoing this approach, we found a statistically significant increase in end‐diastolic pressure, pulmonary artery pressure, and common atrial pressure and a significant decrease in the transpulmonary gradient 5 . Although these changes indicate mild hypoxia secondary to the right‐to‐left shunt caused by the intra/extracardiac fenestration, they also indicate increased left‐sided filling pressures which may be advantageous for increasing cardiac output in the postoperative period.…”

Section: Potential Advantages Of Intra/extracardiac Fenestration For mentioning

confidence: 85%

Fontan procedure: Early outcomes of 87 consecutive patients in a tertiary care center

et al. 2020

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Al Absi and colleagues report their early results of the Fontan procedure in 87 consecutive patients between August 2008 and July 2017 in a tertiary care hospital. The use of the intra/extracardiac fenestration is a promising modification because it is unlikely to be occluded by surrounding tissue and may be associated with decreased pleural effusions, length of hospital stay, and incidence of postoperative arrhythmias.

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Section: Potential Advantages Of Intra/extracardiac Fenestration For mentioning

confidence: 85%

Fontan procedure: Early outcomes of 87 consecutive patients in a tertiary care center

et al. 2020

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“…Routine fenestration for the Fontan circulation is still an area of debate 24–26 . Our decision for fenestration is based on preoperative parameters and/or intraoperative hemodynamics.…”

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confidence: 99%

11 Years of the Fontan operation at a single institution: Results from 87 consecutive patients

et al. 2020

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Fontan procedure is the preferred palliation for patients with single ventricles. Objectives To evaluate early morbidity and mortality after Fontan operation in 87 consecutive patients, between 2007 and 2017. Methods Early survival, duration of intensive care unit (ICU), and hospital stays were the main outcomes evaluated. Potential influencing factors evaluated included preoperative and intraoperative variables. Results Fontan procedure was performed at a median age of 4.2 years (range, 17 months‐26 years), and a median weight of 15.5 kg (range, 8‐72 kg). Extracardiac Fontan was the procedure of choice. The median cardiopulmonary bypass time was 122 minutes (range, 58‐550 minutes). The majority had a fenestration (75 out of 87). Postoperatively, the median duration of ICU stay and total hospital stay were (4, 1‐76 days) and (16, 1‐85 days), respectively. Fontan failure occurred in one patient (1%). Overall early survival was 94%, resulting in a mortality rate of 6%. Univariate analysis showed that heterotaxy (odds ratio [OR], 2.222; confidence interval [CI], 1.345‐6.250; P = .003) and decreased ventricular function (OR, 2.207; CI, 1.348‐6.061; P = .002) significantly decreased survival. The same analysis failed to identify any statistically significant risk factors for prolonged hospital and ICU stays. Conclusion Our reported mortality and morbidity rates compared favorably with the reported rates. Therefore, Fontan operation can be performed in a tertiary care center in the United Arab Emirates with favorable early postoperative outcomes.

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Hemodynamic Changes and Clinical Outcomes after the Intra/Extracardiac Fenestrated Fontan Procedure

Cited by 2 publications

References 23 publications

Fontan procedure: Early outcomes of 87 consecutive patients in a tertiary care center

Fontan procedure: Early outcomes of 87 consecutive patients in a tertiary care center

11 Years of the Fontan operation at a single institution: Results from 87 consecutive patients

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