Faculty Collaboration Database

Comparison of extracardiac Fontan techniques: pedicled pericardial tunnel versus conduit reconstruction. J Thorac Cardiovasc Surg 2003 Mar;125(3):465-71

Date

03/27/2003

Pubmed ID

12658187

DOI

10.1067/mtc.2003.153

Scopus ID

2-s2.0-0037352548 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

OBJECTIVE: This study was designed to determine whether either of 2 alternative methods of extracardiac Fontan reconstruction provides superior results.

METHODS: We reviewed 58 consecutive Fontan procedures performed between 1995 and 2001 with a pedicled pericardial tunnel (group P, n = 21) or an extracardiac conduit of polytetrafluoroethylene or allograft aorta (group C, n = 37). Operations were performed with cardiopulmonary bypass at 32 degrees C; an aortic crossclamp was applied in only 6 patients. All group P patients and 33 (89%) group C patients received fenestrations.

RESULTS: The groups were similar in terms of age, weight, anatomy, and preoperative hemodynamics. There were 3 hospital deaths (5%; 70% confidence limit, 2%-30%), all in group C. Median durations of mechanical ventilation (group P, 1 day; group C, 1 day), intensive care unit stay (group P, 3 days; group C, 3 days), chest tube drainage (group P, 8 days; group C, 7 days), and hospitalization (group P, 10 days; group C, 9 days) were not significantly different. There were no late deaths. All patients received warfarin sodium, and there were no late strokes. Before the Fontan procedure, 1 patient in group P and 3 patients in group C required pacemaker implants. Of the 51 surviving patients in sinus rhythm before the Fontan procedure, only 1 patient in group C subsequently required a pacemaker.

CONCLUSIONS: Extracardiac Fontan procedures with either a pericardial baffle or conduit are associated with low operative mortality and low risks of arrhythmia and late thromboembolic complication.

Author List

Woods RK, Dyamenahalli U, Duncan BW, Rosenthal GL, Lupinetti FM

Author

Ronald K. Woods MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aorta
Arrhythmias, Cardiac
Blood Vessel Prosthesis Implantation
Child, Preschool
Fontan Procedure
Heart Septal Defects
Hospital Mortality
Humans
Hypoplastic Left Heart Syndrome
Infant
Infant, Newborn
Length of Stay
Morbidity
Pericardium
Polytetrafluoroethylene
Pulmonary Atresia
Retrospective Studies
Survival Analysis
Thromboembolism
Treatment Outcome
Tricuspid Atresia