| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The Annals of Thoracic Surgery, Vol 51, 893-899, Copyright © 1991 by The Society of Thoracic Surgeons
EC Douville, RM Sade and DA Fyfe
Mortality after Fontan operation is related to risk factors like
ventricular hypertrophy, pulmonary artery deformity, and young age
(infancy). Preliminary procedures may improve Fontan results. The hemi-
Fontan operation includes atriopulmonary anastomosis and correction of all
anatomical risk factors, but an atriopulmonary patch directs superior vena
caval flow into both pulmonary arteries and inferior vena caval flow into
the ventricle, thus maintaining cardiac output (modified Glenn physiology).
We performed 17 hemi-Fontan procedures in 16 patients, 14 primarily (median
age, 9 months) and 3 for takedown of a Fontan operation. The 14 primary
operations were for hypoplastic left heart syndrome (5), pulmonary atresia
with intact ventricular septum (4), and other (5). All patients had
multiple risk factors. Extubation was at 18 hours (median), chest tube
removal was at 3 days, and hospital discharge was at 8 days
postoperatively. Important complications included subglottic stenosis,
transient diaphragmatic paralysis, pulmonary artery stenosis and thrombosis
requiring reoperation, and transient ventricular fibrillation. One patient
required hemi-Fontan takedown, and this patient later (3 months
postoperatively) became the only death. Fontan take-downs have had a high
mortality rate. In 3 patients who tolerated Fontan operation poorly,
converting Fontan to hemi-Fontan abruptly reversed the downhill course. For
these patients, the operation was life-saving. Hemi-Fontan operation is
safe and well-tolerated, even in infants, provides the advantages of
modified Glenn physiology before Fontan operation, and may be especially
useful for Fontan takedown after failed Fontan.
ARTICLES
Hemi-Fontan operation in surgery for single ventricle: a preliminary report
Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston 29425.
This article has been cited by other articles:
|
|
 |
|
  M. Procelewska, J. Kolcz, K. Januszewska, T. Mroczek, and E. Malec Coagulation abnormalities and liver function after hemi-Fontan and Fontan procedures -- the importance of hemodynamics in the early postoperative period Eur. J. Cardiothorac. Surg., May 1, 2007; 31(5): 866 - 872. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Kawahira, K. Nishigaki, T. Ueno, and N. Sekiya Bidirectional Glenn shunt with concomitant placement of extra-cardiac graft - preparatory procedure for the future total cavo-pulmonary connection Interactive CardioVascular and Thoracic Surgery, December 1, 2005; 4(6): 499 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Januszewska, J. Kolcz, T. Mroczek, M. Procelewska, and E. Malec Right ventricle-to-pulmonary artery shunt and modified Blalock-Taussig shunt in preparation to hemi-Fontan procedure in children with hypoplastic left heart syndrome Eur. J. Cardiothorac. Surg., June 1, 2005; 27(6): 956 - 961. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Mavroudis and R. M. Sade The Southern Thoracic Surgical Association 50th anniversary celebration: the impact of STSA pediatric cardiothoracic surgery manuscripts on surgical practice Ann. Thorac. Surg., November 1, 2003; 76(90050): S47 - 67. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Kawahito, H. Kitahata, K. Tanaka, J. Nozaki, and S. Oshita Intraoperative Evaluation of Pulmonary Artery Flow During the Fontan Procedure by Transesophageal Doppler Echocardiography Anesth. Analg., December 1, 2000; 91(6): 1375 - 1380. [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]
|
|
|
|
|
|
W. I. Douglas, C. S. Goldberg, R. S. Mosca, I. H. Law, and E. L. Bove Hemi-Fontan procedure for hypoplastic left heart syndrome: outcome and suitability for Fontan Ann. Thorac. Surg., October 1, 1999; 68(4): 1361 - 1367. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. P. Santamore, O. Barnea, C. J. Riordan, M. P. Ross, and E. H. Austin Theoretical optimization of pulmonary-to-systemic flow ratio after a bidirectional cavopulmonary anastomosis Am J Physiol Heart Circ Physiol, February 1, 1998; 274(2): H694 - H700. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. C. Koutlas, J. W. Gaynor, S. C. Nicolson, J. M. Steven, G. Wernovsky, and T. L. Spray Modified Ultrafiltration Reduces Postoperative Morbidity After Cavopulmonary Connection Ann. Thorac. Surg., July 1, 1997; 64(1): 37 - 42. [Abstract] [Full Text]
|
|
|
|
|
|
L. Mace, P. Dervanian, J. Losay, T. A. Folliguet, J.-M. Grinda, S. Abdelmoulah, J.-F. Verrier, F. Santoro, and J.-Y. Neveux Bidirectional Inferior Vena Cava-Pulmonary Artery Shunt Ann. Thorac. Surg., May 1, 1997; 63(5): 1321 - 1325. [Abstract] [Full Text]
|
|
|
|
|
|
M. L. Jacobs, J. Rychik, J. J. Rome, S. Apostolopoulou, C. Pizarro, J. D. Murphy, and W. I. Norwood Jr Early Reduction of the Volume Work of the Single Ventricle: The Hemi-Fontan Operation Ann. Thorac. Surg., August 1, 1996; 62(2): 456 - 461. [Abstract] [Full Text]
|
|
|
|
|
|
K. Bando, M. W. Turrentine, K. Sun, T. G. Sharp, R. L. Caldwell, R. K. Darragh, G. J. Ensing, T. M. Cordes, T. Flaspohler, and J. W. Brown Surgical Management of Hypoplastic Left Heart Syndrome Ann. Thorac. Surg., July 1, 1996; 62(1): 70 - 76. [Abstract] [Full Text]
|
|
|
|
|
|
P. B. Manning, J. E. Mayer Jr., G. Wernovsky, S. B. Fishberger, and E. P. Walsh STAGED OPERATION TO FONTAN INCREASES THE INCIDENCE OF SINOATRIAL NODE DYSFUNCTION J. Thorac. Cardiovasc. Surg., April 1, 1996; 111(4): 833 - 840. [Abstract] [Full Text]
|
|
|
|
 |
|
 H. Uemura, T. Yagihara, Y. Kawashima, K. Okada, T. Kamiya, and R. H. Anderson Use of the Bidirectional Glenn Procedure in the Presence of Forward Flow From the Ventricles to the Pulmonary Arteries Circulation, November 1, 1995; 92(9): 228 - 232. [Abstract] [Full Text]
|
|
|
|
|
|
S. A. Webber, P. Horvath, J. G. LeBlanc, Z. Slavik, R. K. Lamb, J. L. Monro, O. Reich, J. Hruda, G. G.S. Sandor, B. R. Keeton, et al. Influence of Competitive Pulmonary Blood Flow on the Bidirectional Superior Cavopulmonary Shunt : A Multi-Institutional Study Circulation, November 1, 1995; 92(9): 279 - 286. [Abstract] [Full Text]
|
|
|
|
|
|
R. D. Mainwaring, J. J. Lamberti, K. Uzark, and R. L. Spicer Bidirectional Glenn : Is Accessory Pulmonary Blood Flow Good or Bad? Circulation, November 1, 1995; 92(9): 294 - 297. [Abstract] [Full Text]
|
|
|
|
|
|
C. J. Knott-Craig, G. K. Danielson, H. V. Schaff, F. J. Puga, A. L. Weaver, and D. D. Driscoll The modified fontan operationAn analysis of risk factors for early postoperative death or takedown in 702 consecutive patients from one institution J. Thorac. Cardiovasc. Surg., June 1, 1995; 109(6): 1237 - 1243. [Abstract] [Full Text]
|
|
|
|
|
|
P. W. Weldner, J. L. Myers, M. M. Gleason, S. E. Cyran, H. S. Weber, M. G. White, and B. G. Baylen The Norwood operation and subsequent Fontan operation in infants with complex congenital heart disease J. Thorac. Cardiovasc. Surg., April 1, 1995; 109(4): 654 - 662. [Abstract] [Full Text]
|
|
|
|
|
|
M. D. Iannettoni, E. L. Bove, R. S. Mosca, F. M. Lupinetti, P. C. Dorostkar, A. Ludomirsky, D. C. Crowley, T. J. Kulik, and A. Rosenthal Improving results with first-stage palliation for hypoplastic left heart syndrome J. Thorac. Cardiovasc. Surg., March 1, 1994; 107(3): 934 - 940. [Abstract] [Full Text]
|
|
| 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 |
