Original articlePediatric cardiacVentricular Performance in Long-Term Survivors After Fontan Operation
Section snippets
Patients
Between October 1979 and May 1992, 110 patients underwent Fontan operations at our institution. There were 26 hospital deaths and 18 late deaths. Causes of hospital deaths were Fontan circulation failure due to ventricular dysfunction or pulmonary condition in 19 patients and noncardiac event in 7 patients. Causes of late deaths were Fontan circulation failure due to ventricular dysfunction in 4 patients, Fontan circulation failure due to pathway obstruction in 6 patients, intractable atrial
Results
Mean follow-up period after Fontan operation was 18.5 ± 3.2 years. Mean age at last follow-up was 24.8 ± 5.4 years.
A total of 4 patients, 1 in the APC group and 3 in the TCPC group, suffered from protein losing enteropathy. The patient in the APC group underwent Fontan conversion 14 years after APC-type Fontan operation, but protein losing enteropathy PLE persisted. As for thromboembolic events, 3 patients in the APC group suffered from brain infarction.
Of the 26 patients in the APC group, 15
Comment
In this study we analyzed the serial changes in parameters at cardiac catheterization and exercise test every 5 years in Fontan patients post surgery. We admit that the parameters measured did not reflect actual functional class because cardiac catheterization was performed with the patient under sedation [9]. Nonetheless, we could find the trend of cardiopulmonary parameters during the 15-year follow-up.
Cardiac index in the APC group began to decrease after 10 years post surgery. It was lower
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2021, International Journal of CardiologyCardiopulmonary exercise testing in the evaluation of liver disease in adults who have had the Fontan operation
2018, Archives of Cardiovascular DiseasesCitation Excerpt :However, other potential mechanisms that have been postulated include pre-Fontan hypoxaemia [26], perioperative liver injury [27] and altered hepatic blood flow [28]. The long-term compromise of relatively low cardiac output after the Fontan operation [29] might chronically reduce the hepatic blood supply and compromise the ability of the hepatic artery to increase blood supply [8] by decreasing the flow reserve. Peak VO2 is considered to be the metric that defines the limits of the cardiopulmonary system [30].