| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 1999;117:688-696
© 1999 Mosby, Inc.
SURGERY FOR CONGENITAL HEART DISEASE |
From the Division of Cardiothoracic Surgery, University of California, San Francisco, Calif.
Presented in part at The Second World Congress of Pediatric Cardiology and Cardiac Surgery, Honolulu, Hawaii, May 1997.
Received for publication Feb 17, 1998. Revisions requested April 29, 1998. Revisions received Dec 14, 1998. Accepted for publication Dec 21, 1998. Address for reprints: Ed Petrossian, MD, UCSF Pediatric Cardiac Surgery, Valley Children's Hospital, 9300 Valley Children's Place, Madera, CA 93638.
Background: Among the modifications of the Fontan operation, the extracardiac approach may offer the greatest potential for optimizing early postoperative ventricular and pulmonary vascular function, insofar as it can be performed with short periods of normothermic partial cardiopulmonary bypass and without cardioplegic arrest in most cases. In this study, we reviewed our experience with the extracardiac conduit Fontan operation, with a focus on early postoperative outcomes.
Methods and results: Between July 1992 and April 1997, 51 patients (median age 4.9 years) underwent an extracardiac conduit Fontan operation. Median cardiopulmonary bypass time was 92 minutes and has decreased significantly over the course of our experience. Intracardiac procedures were performed in only 5 patients (10%), and the aorta was crossclamped in only 11 (22%). Intraoperative fenestration was performed in 24 patients (47%). There were no early deaths. Fontan failure occurred in 1 patient who was a poor candidate for the Fontan procedure. Transient supraventricular tachyarrhythmias occurred in 5 patients (10%). Median duration of chest tube drainage was 8 days. Factors significantly associated with prolonged resource use (mechanical ventilation, inotropic support, intensive care unit stay, and hospital stay) included longer bypass time and higher Fontan pressure. At a median follow-up of 1.9 years, there was 1 death from bleeding at reoperation.
Conclusions: The extracardiac conduit Fontan procedure can be performed with minimal mortality and morbidity. Improved results may be related to advantages of the extracardiac approach and improved preservation of ventricular and pulmonary vascular function.
This article has been cited by other articles:
|
|
 |
|
  S. Silvilairat, Y. Pongprot, R. Sittiwangkul, S. Woragidpoonpol, S. Chuaratanaphong, and W. Nawarawong Factors Influencing Survival in Patients After Bidirectional Glenn Shunt Asian Cardiovasc Thorac Ann, October 1, 2008; 16(5): 381 - 386. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W. Salvin, M. A. Scheurer, P. C. Laussen, J. E. Mayer Jr, P. J. del Nido, F. A. Pigula, E. A. Bacha, and R. R. Thiagarajan Factors Associated With Prolonged Recovery After the Fontan Operation Circulation, September 30, 2008; 118(14_suppl_1): S171 - S176. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Yoshimura, R. Henaine, Y. Ootaki, H. Matsuhisa, and T. Misaki Why does the preoperative BNP level predict the degree of postoperative BNP elevation? Ann. Thorac. Surg., August 1, 2008; 86(2): 694 - 694. [Full Text] [PDF]
|
|
|
|
|
|
C. S.D. Almond, J. E. Mayer Jr, R. R. Thiagarajan, E. D. Blume, P. J. del Nido, and D. B. McElhinney Outcome After Fontan Failure and Takedown to an Intermediate Palliative Circulation Ann. Thorac. Surg., September 1, 2007; 84(3): 880 - 887. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Lee, C.-H. Lee, S. W. Hwang, H. G. Lim, S.-J. Kim, J. Y. Lee, W.-S. Shim, and W.-H. Kim Midterm follow-up of the status of Gore-Tex graft after extracardiac conduit Fontan procedure Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1008 - 1012. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Petrossian, V. M. Reddy, K. K. Collins, C. B. Culbertson, M. J. MacDonald, J. J. Lamberti, O. Reinhartz, R. D. Mainwaring, P. D. Francis, S. P. Malhotra, et al. The extracardiac conduit Fontan operation using minimal approach extracorporeal circulation: early and midterm outcomes. J. Thorac. Cardiovasc. Surg., November 1, 2006; 132(5): 1054 - 1063. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. S. Bleiweis and A. Saidi Advances in Neonatal Cardiac Surgery: Historical Perspective and Current Status NeoReviews, September 1, 2006; 7(9): e463 - e473. [Full Text] [PDF]
|
|
|
|
|
|
J.-P. Xu, X.-J. Luo, J.-M. Chu, S.-J. Li, and Y.-L. Liu Total Cavopulmonary Connection with Off-Pump Technique Asian Cardiovasc Thorac Ann, September 1, 2005; 13(3): 225 - 228. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. N. Kavarana, S. Pagni, M. R. Recto, W. L. Sobczyk, T. Yeh Jr, M. Mitchell, and E. H. Austin III Seven-Year Clinical Experience With the Extracardiac Pedicled Pericardial Fontan Operation Ann. Thorac. Surg., July 1, 2005; 80(1): 37 - 43. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. G. Lim, W.-H. Kim, S.-S. Oh, C. Lim, S.-J. Kim, Y. T. Lee, and S.-C. Kim Alternative Fontan Connection for Apicocaval Juxtaposition Ann. Thorac. Surg., March 1, 2005; 79(3): 1047 - 1049. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. H. Nurnberg, S. Ovroutski, V. Alexi-Meskishvili, P. Ewert, R. Hetzer, and Peter. E. Lange New Onset Arrhythmias After the Extracardiac Conduit Fontan Operation Compared With the Intraatrial Lateral Tunnel Procedure: Early and Midterm Results Ann. Thorac. Surg., December 1, 2004; 78(6): 1979 - 1988. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Kreutzer Reply Ann. Thorac. Surg., December 1, 2004; 78(6): 2211 - 2211. [Full Text] [PDF]
|
|
|
|
|
|
S. Ovroutski, P. Ewert, V. Alexi-Meskishvili, B. Stiller, J.-H. Nurnberg, H. Abdul-Khaliq, R. Hetzer, and P. E. Lange Comparison of somatic development and status of conduit after extracardiac Fontan operation in young and older children Eur. J. Cardiothorac. Surg., December 1, 2004; 26(6): 1073 - 1079. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Giamberti and A. Frigiola Fenestration in Extracardiac-Conduit Fontan Operation Ann. Thorac. Surg., December 1, 2004; 78(6): 2210 - 2211. [Full Text] [PDF]
|
|
|
|
|
|
A. Gupta, C. Daggett, S. Behera, M. Ferraro, W. Wells, and V. Starnes Risk factors for persistent pleural effusions after the extracardiac Fontan procedure J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1664 - 1669. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Nakano, H. Kado, S. Ishikawa, Y. Shiokawa, H. Ushinohama, K. Sagawa, N. Fusazaki, Y. Nishimura, Y. Tanoue, T. Nakamura, et al. Midterm surgical results of total cavopulmonary connection: clinical advantages of the extracardiac conduit method J. Thorac. Cardiovasc. Surg., March 1, 2004; 127(3): 730 - 737. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Isomatsu, T. Shin'oka, G. Matsumura, N. Hibino, T. Konuma, M. Nagatsu, and H. Kurosawa Extracardiac total cavopulmonary connection using a tissue-engineered graft J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1958 - 1962. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Lee, J. S. Choi, C. H. Kang, E. J. Bae, Y. J. Kim, and J. R. Rho Surgical results of patients with a functional single ventricle Eur. J. Cardiothorac. Surg., November 1, 2003; 24(5): 716 - 722. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Kreutzer, A. J. Schlichter, J. L. Simon, W. M. Conejeros Parodi, C. Blunda, and G. O. Kreutzer A new method for reliable fenestration in extracardiac conduit Fontan operations Ann. Thorac. Surg., May 1, 2003; 75(5): 1657 - 1659. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Ovroutski, V. Alexi-Meskishvili, P. Ewert, J.-H. Nurnberg, R. Hetzer, and P.E. Lange Early and medium-term results after modified Fontan operation in adults Eur. J. Cardiothorac. Surg., March 1, 2003; 23(3): 311 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. K. Woods, U. Dyamenahalli, B. W. Duncan, G. L. Rosenthal, and F. M. Lupinetti Comparison of extracardiac Fontan techniques: Pedicled pericardial tunnel versus conduit reconstruction J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(3): 465 - 471. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Stamm, I. Friehs, L. F. Duebener, D. Zurakowski, J. E. Mayer Jr, R. A. Jonas, and P. J. del Nido Improving results of the modified Fontan operation in patients with heterotaxy syndrome Ann. Thorac. Surg., December 1, 2002; 74(6): 1967 - 1978. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. H. Schoof, A. D. Koch, M. G. Hazekamp, T. W. Waterbolk, T. Ebels, and R. A. Dion Bovine jugular vein thrombosis in the Fontan circulation J. Thorac. Cardiovasc. Surg., November 1, 2002; 124(5): 1038 - 1040. [Full Text] [PDF]
|
|
|
|
|
|
M. Nanaumi, T. Asou, Y. Takeda, Z.-B. Lin, K. Ohara, and H. Yoshimura Total cavopulmonary connection via a thoracotomy Ann. Thorac. Surg., September 1, 2002; 74(3): 917 - 919. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Aeba, T. Katogi, K. Hashizume, Y. Iino, S. Kawada, and Y. Yuasa Individualized total cavopulmonary connection technique for patients with Asplenia syndrome Ann. Thorac. Surg., April 1, 2002; 73(4): 1274 - 1280. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Lee, C. Lee, J. M. Chang, E. J. Bae, and C. I. Noh Modified extracardiac Fontan in a patient with separate hepatic venous drainage Ann. Thorac. Surg., March 1, 2002; 73(3): 992 - 993. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Tokunaga, H. Kado, Y. Imoto, M. Masuda, Y. Shiokawa, K. Fukae, N. Fusazaki, S. Ishikawa, and H. Yasui Total cavopulmonary connection with an extracardiac conduit: experience with 100 patients Ann. Thorac. Surg., January 1, 2002; 73(1): 76 - 80. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Azakie, B. W. McCrindle, G. Van Arsdell, L. N. Benson, J. Coles, R. Hamilton, R. M. Freedom, and W. G. Williams Extracardiac conduit versus lateral tunnel cavopulmonary connections at a single institution: Impact on outcomes J. Thorac. Cardiovasc. Surg., December 1, 2001; 122(6): 1219 - 1228. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. T. Fedderly, B. N. Whitstone, S. J. Frisbee, J. S. Tweddell, and S. B. Litwin Factors Related to Pleural Effusions After Fontan Procedure in the Era of Fenestration Circulation, September 18, 2001; 104(90001): I-148 - 151. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Bradley, M. M. McCall, J. J. Sistino, and W. A.K. Radtke Aortopulmonary collateral flow in the Fontan patient: does it matter? Ann. Thorac. Surg., August 1, 2001; 72(2): 408 - 415. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Azakie, B. W. McCrindle, L. N. Benson, G. S. Van Arsdell, J. L. Russell, J. G. Coles, D. Nykanen, R. M. Freedom, and W. G. Williams Total cavopulmonary connections in children with a previous Norwood procedure Ann. Thorac. Surg., May 1, 2001; 71(5): 1541 - 1546. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Gaca, W. I. Douglas, and S. D. Barnes Anesthetic Implications of the Fontan Procedure for Single Ventricle Physiology Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2001; 5(1): 31 - 39. [Abstract] [PDF]
|
|
|
|
 |
|
 D. D. Mair, F. J. Puga, and G. K. Danielson The Fontan procedure for tricuspid atresia: early and late results of a 25-year experience with 216 patients J. Am. Coll. Cardiol., March 1, 2001; 37(3): 933 - 939. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Alexi-Meskishvili, S. Ovroutski, I. Dahnert, P. E. Lange, and R. Hetzer Early experience with extracardiac Fontan operation Ann. Thorac. Surg., January 1, 2001; 71(1): 71 - 76. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Stamm, I. Friehs, J. E. Mayer Jr, D. Zurakowski, J. K. Triedman, A. M. Moran, E. P. Walsh, J. E. Lock, R. A. Jonas, and P. J. del Nido Long-term results of the lateral tunnel Fontan operation J. Thorac. Cardiovasc. Surg., January 1, 2001; 121(1): 0028 - 41. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Alexi-Meskishvili, S. Ovroutski, P. Ewert, I. Dahnert, F. Berger, P. E. Lange, and R. Hetzer Optimal conduit size for extracardiac Fontan operation Eur. J. Cardiothorac. Surg., December 1, 2000; 18(6): 690 - 695. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. I. Cohen, N. D. Bridges, J. W. Gaynor, T. M. Hoffman, G. Wernovsky, V. L. Vetter, T. L. Spray, and L. A. Rhodes Modifications to the cavopulmonary anastomosis do not eliminate early sinus node dysfunction J. Thorac. Cardiovasc. Surg., November 1, 2000; 120(5): 891 - 901. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Yoshimura, M. Yamaguchi, Y. Oshima, S. Oka, Y. Ootaki, T. Hasegawa, and C. Shimazu Suppression of the secretion of atrial and brain natriuretic peptide after total cavopulmonary connection J. Thorac. Cardiovasc. Surg., October 1, 2000; 120(4): 764 - 769. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Mosca, T. J. Kulik, C. S. Goldberg, R. P. Vermilion, J. R. Charpie, D. C. Crowley, and E. L. Bove EARLY RESULTS OF THE FONTAN PROCEDURE IN ONE HUNDRED CONSECUTIVE PATIENTS WITH HYPOPLASTIC LEFT HEART SYNDROME J. Thorac. Cardiovasc. Surg., June 1, 2000; 119(6): 1110 - 1118. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. I. Tchervenkov, M. L. Jacobs, and S. A. Tahta Congenital Heart Surgery Nomenclature and Database Project: hypoplastic left heart syndrome Ann. Thorac. Surg., April 1, 2000; 69(4): S170 - 179. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. F. Marcelletti, F. L. Hanley, C. Mavroudis, D. B. McElhinney, R. F. Abella, S. M. Marianeschi, F. Seddio, V. M. Reddy, E. Petrossian, T. de la Torre, et al. REVISION OF PREVIOUS FONTAN CONNECTIONS TO TOTAL EXTRACARDIAC CAVOPULMONARY ANASTOMOSIS: A MULTICENTER EXPERIENCE J. Thorac. Cardiovasc. Surg., February 1, 2000; 119(2): 340 - 346. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Ziemer and M. K. Heinemann Preparatory surgical stent placement facilitating extracardiac vascular connections Ann. Thorac. Surg., October 1, 1999; 68(4): 1431 - 1432. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Jonas Commentary J. Thorac. Cardiovasc. Surg., August 1, 1999; 118(2): 368 - 368. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
