Original articlePediatric cardiacPerioperative Risks and Outcomes of Atrioventricular Valve Surgery in Conjunction With Fontan Procedure
Section snippets
Patients
This study was conducted with the approval of the Emory University institutional review board with a waiver for individual patient consent. From January 2002 until January 2008, 236 modified Fontan procedures were performed for congenital anomalies with single-ventricle physiology. Data were prospectively entered into our institutional congenital cardiac surgery database and were retrospectively reviewed. Among the patients reviewed, 21 (8.9%) were identified who underwent concomitant AVV
Perioperative Variables
Patients undergoing AVV surgery were older (4.3 ± 3.7 versus 3.0 ± 2.6 years; p = 0.04), but there was no difference in mean preoperative weight or sex (Table 2). Total CPB time (118 ± 38 versus 85 ± 28 minutes; p < 0.001) and aortic cross-clamp time (33 ± 32 versus 14 ± 21 minutes; p < 0.001) were significantly longer among those undergoing AVV surgery. There were no differences between groups regarding diagnosis, hospital or intensive care unit length of stay, ventilator time, or 12-hour
Comment
Early outcomes of the modified Fontan procedure for palliation of single-ventricle physiology have vastly improved since it was first introduced more than 30 years ago, as evidenced by the 0.4% operative mortality in this series of 236 patients. These results are consistent with previously published large series, which have demonstrated superb early results with operative mortality of less than 5% [6, 7, 8, 9, 10]. In addition, results of long-term follow-up studies have demonstrated 10-year
References (31)
- et al.
Total cavopulmonary connection: a logical alternative to atriopulmonary connection for complex Fontan operationsExperimental studies and early clinical experience
J Thorac Cardiovasc Surg
(1988) - et al.
Contemporary outcomes after the Fontan procedure: a Pediatric Heart Network multicenter study
J Am Coll Cardiol
(2008) - et al.
Atrioventricular valve regurgitation in patients with single ventricle: impact of the bidirectional cavopulmonary anastomosis
Ann Thorac Surg
(2001) - et al.
Semiquantitative assessment of mitral regurgitation by Doppler color flow imaging in patients aged < 20 years
Am J Cardiol
(1993) - et al.
Outcomes of the Fontan procedure using cardiopulmonary bypass with aortic cross-clamping
Ann Thorac Surg
(2006) - et al.
Lateral tunnel versus extracardiac conduit Fontan procedure: a concurrent comparison
Ann Thorac Surg
(2003) - et al.
Outcome of 200 patients after an extracardiac Fontan procedure
J Thorac Cardiovasc Surg
(2008) - et al.
Excellent midterm outcome of extracardiac conduit total cavopulmonary connection: results of 126 cases
Ann Thorac Surg
(2007) - et al.
Long-term results of the lateral tunnel Fontan operation
J Thorac Cardiovasc Surg
(2001) - et al.
Predictors of outcome after the Fontan operation: is hypoplastic left heart syndrome still a risk factor?
J Thorac Cardiovasc Surg
(2002)