Results of Fontan operation in patients with atrioventricular valve regurgitation

Подзолков, В. И.; Чиаурели, М.Р.; Yurlov, I.A.; Зеленикин, М.М.; Ковалев, Д.В.; Донцова, В.И.; Астраханцева, Т.О.; Путято, Н.А.; Zaets, Sergey B.

doi:10.1093/ejcts/ezu489

Cited by 21 publications

(13 citation statements)

References 13 publications

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“…Several studies have demonstrated that an independent risk factor for late outcomes after the Fontan operation is AV valve regurgitation prior to Fontan. 4,[12][13][14][15] There have been several proposed mechanisms of AV valve regurgitation in the single ventricular heart, including volume overload with a systemic-to-pulmonary shunt, annular dilation, and abnormal chordae and papillary muscles. 10,16 Kotani and colleagues 17 showed that valve repair in cases of moderate or severe AV regurgitation, which occurs between the stages of Fontan surgery, may be beneficial in preventing deterioration of ventricular contraction.…”

Section: Discussionmentioning

confidence: 99%

Survival and predictors of mortality in patients after the Fontan operation

Sethasathien

Silvilairat

Kraikruan

et al. 2020

Asian Cardiovasc Thorac Ann

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Background As a result of the surgical techniques now being employed, the survival rate in patients after undergoing the Fontan operation has improved. The aims of this study were focused on determining the survival rate and predictors of early mortality. Methods In a retrospective cohort study, 117 consecutive patients who underwent the Fontan operation were recruited. Multivariate Cox proportional regression analysis was used to assess the predictors of early mortality, defined as death within 30 days after the Fontan operation. Results The median follow-up time was 6.1 years. The median age at the time of the Fontan operation was 5.7 years. Survival rates in the patients at 5, 10, and 15 years postoperatively were 92%, 87% and 84%, respectively. Using univariate Cox regression analysis, the predictors of early mortality were found to be postoperative mean pulmonary artery pressure ≥23 mm Hg (hazard ratio 26.0), renal failure (hazard ratio 9.5), heterotaxy syndrome (hazard ratio 5.3), and uncorrected moderate or severe atrioventricular valve regurgitation (hazard ratio 9.4). After adjusting for confounding factors using multivariate Cox regression analysis, the predictors of early mortality were found to be postoperative mean pulmonary artery pressure ≥23 mm Hg (hazard ratio 23.2) and uncorrected moderate or severe atrioventricular valve regurgitation (hazard ratio 8.2). Conclusions Uncorrected moderate or severe atrioventricular valve regurgitation and postoperative mean pulmonary artery pressure ≥23 mm Hg are independent predictors of early mortality after the Fontan operation. Patients with these factors should undergo aggressive management to minimize morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Survival and predictors of mortality in patients after the Fontan operation

Sethasathien

Silvilairat

Kraikruan

et al. 2020

Asian Cardiovasc Thorac Ann

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“…8 Podzolkov et al also found that, if unrepaired, concomitant moderate to severe A-V valve regurgitation significantly worsens the results of Fontan procedure. 9 In the present case after TEE examination, a surgical decision of right A-V valve replacement was taken as the inadequate repair of valve could significantly increase…”

Section: Discussionmentioning

confidence: 82%

Transesophageal Echocardiographic Evaluation of Crisscross Heart with Atrioventricular Valve Regurgitation for Fontan Procedure

Saxena¹,

Talwar²,

Bhardwaj³

et al. 2016

Journal of Perioperative Echocardiography

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Crisscross heart (CCH) is a rare congenital cardiac malformation characterized by crossing of systemic and pulmonary venous blood streams at atrioventricular (A-V) level due to an apparent twisting of the heart about its long axis. In the literature, perioperative evaluation of CCH by transesophageal echocardiography (TEE) has not been described. Here we report a rare case of CCH, post Glenn procedure with A-V valve regurgitation, evaluated by TEE for valve repair/replacement followed by completion of Fontan surgery. How to cite this article Makhija N, Bhardwaj V, Saxena A, Talwar S. Transesophageal Echocardiographic Evaluation of Crisscross Heart with Atrioventricular Valve Regurgitation for Fontan Procedure. J Perioper Echocardiogr 2016;4(1):27-29.

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“…King et al 5 also reported a twofold increase in the risk of Fontan failure in patients with atrioventricular valve regurgitation into the pulmonary veins which negatively affects the pulmonary venous return. Podzolkov et al 6 also reported the risk of atrioventricular valve regurgitation, affecting the ejection fraction and survival of patients with Fontan surgery, with half of the patients progressing to Fontan failure within 20 years of completion. It is therefore reasonable to consider closure of the nonessential regurgitant left atrioventricular valve in such patients.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous transcatheter occlusion of left atrioventricular valve in a patient with single ventricle and severe atrioventricular valve regurgitation

Nasef

Oslizlok

Walsh

2020

Cathet Cardio Intervent

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Many patients with single ventricle physiology suffer from atrioventricular valve (AVV) regurgitation which may worsen their cardiac function and cause symptoms. It has been postulated that elimination of the nondominant hypoplastic AVV regurgitation, might improve the clinical status in patients post‐Fontan surgery. We describe a case of hypoplastic left heart variant, post Fontan surgery who had severe left AVV regurgitation and underwent percutaneous transcatheter occlusion of the hypoplastic left AVV, using a VSD occluder device. At 3 months post procedure, the patient is improved. Transcatheter closure of a regurgitant hypoplastic AVV in a patient with single ventricle helps to improve the patient's cardiac function and clinical status.

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Results of Fontan operation in patients with atrioventricular valve regurgitation

Cited by 21 publications

References 13 publications

Survival and predictors of mortality in patients after the Fontan operation

Survival and predictors of mortality in patients after the Fontan operation

Transesophageal Echocardiographic Evaluation of Crisscross Heart with Atrioventricular Valve Regurgitation for Fontan Procedure

Percutaneous transcatheter occlusion of left atrioventricular valve in a patient with single ventricle and severe atrioventricular valve regurgitation

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