Faculty Collaboration Database

Fontan fenestration closure and event-free survival. J Thorac Cardiovasc Surg 2013 Jan;145(1):183-7

Date

10/16/2012

Pubmed ID

23062415

Pubmed Central ID

PMC4610721

DOI

10.1016/j.jtcvs.2012.09.006

Scopus ID

2-s2.0-84871208431 (requires institutional sign-in at Scopus site)   24 Citations

Abstract

OBJECTIVES: The purpose of the present study was to evaluate the association of open and closed Fontan fenestration status with event-free survival.

METHODS: All patients who underwent a fenestrated Fontan procedure at our institution from January 1994 through June 2007 were reviewed. Patient information was obtained from the medical records. The patients were assigned to 1 of 2 study groups, open or closed, according to their most recent fenestration status. Clinically relevant morbid events were tabulated, and Kaplan-Meier event analysis was used to create event-free probability curves with log-rank comparisons.

RESULTS: A total of 161 patients were classified as open and 51 as closed. The median interval to an event was 1.1 years (interquartile range, 0.1-3.3 years) after the Fontan procedure. The median interval to closure was 1.2 years (interquartile range, 0.7-3.3 years). The median interval to an event was 1.5 years (interquartile range, 0.1-4.6 years) in the closed group and 1.1 years (interquartile range, 0.1-3.3 years) in the open group. Event-free probability analysis revealed no significant difference between the 2 groups (P = .15). The median follow-up arterial oxygen saturation was greater in the closed group (96.0%; interquartile range, 94.0%-97.0%) than in the open group (91.0%; interquartile range, 86.0%-95.0%; P < .0001).

CONCLUSIONS: Fenestration closure was associated with greater arterial oxygen saturation but not greater event-free survival. The interval to an event was slightly less than the interval to fenestration closure, suggesting potential merit in the evaluation of earlier fenestration closure. Adoption of specific fenestration management guidelines might help improve the overall outcomes and enhance the quality of future studies.

Author List

Imielski BR, Woods RK, Mussatto KA, Cao Y, Simpson PM, Tweddell JS

Authors

Kathleen Mussatto Ph.D. Associate Professor in the School of Nursing department at Milwaukee School of Engineering
Pippa M. Simpson PhD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
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

Chi-Square Distribution
Child, Preschool
Disease-Free Survival
Female
Fontan Procedure
Heart Defects, Congenital
Humans
Kaplan-Meier Estimate
Male
Oxygen
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome