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Erschienen in: Heart and Vessels 4/2020

27.09.2019 | Original Article

Forns Index is a predictor of cardiopulmonary bypass time and outcomes in Fontan conversion

verfasst von: Gaku Izumi, Atsuhito Takeda, Hirokuni Yamazawa, Osamu Sasaki, Nobuyasu Kato, Hidetsugu Asai, Tsuyoshi Tachibana, Yoshiro Matsui

Erschienen in: Heart and Vessels | Ausgabe 4/2020

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Abstract

Recent reports suggested that cardiopulmonary bypass (CPB) time is one of the risk factors for postoperative complications after Fontan conversion. Although Fontan conversion may be performed for the patients with hepatic fibrosis after initial Fontan procedure, there is no predictive indicator regarding the liver function associated with hemostasis which can affects CPB time. Thirty-one patients who underwent Fontan conversion using the same surgical procedure (extracardiac conduit conversion with right atrium exclusion) were enrolled. In multivariate analyses including age at Fontan conversion, interval from initial Fontan to conversion, hemodynamic data such as right atrial pressure, ventricular end-diastolic pressure, and cardiac index, hepatic data such as platelet count, prothrombin time international normalized ratios, serum total bilirubin, hyaluronic acid levels, five known indices for hepatic fibrosis (Forns Index, APRI, FIB4, FibroIndex, and MELD-XI), and liver stiffness measured by ultrasound elastography, only the Forns Index remained independently associated with the CPB time (P < 0.01) and blood transfusions (plasma transfusions and platelet concentrations: P < 0.01 for both). The cutoff level for Forns Index to predict the prolonged CPB time (exceeding 240 min) was 4.85 by receiver-operating characteristic curve (area under the curve 0.823, sensitivity 76.9%, and specificity 72.2%). Three patients with Forns Index > 7.0 had poor outcomes with long CPB time and massive blood transfusions in contrast with the other 28 patients. In conclusion, Forns Index could serve as a practical predictor of CPB time and is associated with blood transfusion volume in Fontan conversion.
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Metadaten
Titel
Forns Index is a predictor of cardiopulmonary bypass time and outcomes in Fontan conversion
verfasst von
Gaku Izumi
Atsuhito Takeda
Hirokuni Yamazawa
Osamu Sasaki
Nobuyasu Kato
Hidetsugu Asai
Tsuyoshi Tachibana
Yoshiro Matsui
Publikationsdatum
27.09.2019
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 4/2020
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-019-01515-w

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