Outcome of Late Extracardiac Fontan Completion in
Functional Single Ventricle Patients
Karunasumetta C, MD¹, Wongbhuddha C, MD¹, Chanmeka T, MD¹, Mitprachapranee C, MD¹, Prathanee S, MD¹
Affiliation : ¹ Division of Cardiothoracic Surgery, Department of Surgery, Srinagarind Hospital and Queen Sirikit Heart Center of the Northeast, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective: To determine the clinical outcomes and factors influencing the results of late Fontan completion in functional single
ventricle patients.
Material and Methods : The authors retrospectively analyzed data in functional single ventricle patients that underwent late Fontan completion (age more than four-year-old) between January 2007 and December 2017.
Results: The extracardiac conduit Fontan procedure was performed in thirty-six patients over four years old (median age 10 years). The early mortality rate was 11% and the overall mortality was 16%. According to the Cox regression analysis, pulmonary artery pressure greater than 15 mmHg was an unfavorable factor for hospital death. Other morbidities included persistent pleural effusion (44%), chylothorax (2.78%), early atrial tachycardia (5.56%), early graft thrombosis (5.56%), and late graft thrombosis (2.78%).
Conclusion: Late extracardiac conduit Fontan completion yielded acceptable outcomes. The authors found pulmonary artery pressure greater than 15 mmHg to be a risk factor for early mortality. Prevalence of postoperative persistent pleural effusion was higher in older patients, while rates of other complications did not differ from other age groups.
Keywords : Fontan operation, Late Fontan operation, Single ventricle, Functional single ventricle, Univentricular heart
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