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The Annals of Thoracic Surgery, Vol 58, 1409-1413, Copyright © 1994 by The Society of Thoracic Surgeons
M Jahangiri, DB Ross, AN Redington, C Lincoln and EA Shinebourne
The frequency of thromboembolism after the Fontan procedure has not been
specifically addressed. Seventy patients underwent this operation between
1987 and 1992, and complete information was available on 64. Forty-five had
a right atrium-pulmonary artery anastomosis, 17 had a total cavopulmonary
connection, and 2 had a right atrium-right ventricle anastomosis. No
patient received anticoagulants for more than 8 months postoperatively.
Seven patients died in the early postoperative period (< 30 days). Ten
cases of thromboembolism were identified in the follow-up, which ranged
from 6 to 55 months (mean follow-up, 24.5 +/- 17 months). They occurred 7
days to 4.5 years after the Fontan repair. Seven thombi were on the
systemic venous or pulmonary aspect of the circulation and three, on the
systemic arterial aspect. Freedom from thromboembolism was 75% at 4 years.
We conclude that thromboembolism is common after the Fontan procedure; it
can occur several days to years postoperatively; it is an important cause
of morbidity; and it may partly explain late death after the Fontan
operation. Our data suggest that all patients undergoing this procedure
require long-term anticoagulant therapy.
ARTICLES
Thromboembolism after the Fontan procedure and its modifications
Department of Paediatric Cardiology, Royal Brompton National Heart and Lung Hospital, London, England.
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M. A. Fogel, P. M. Weinberg, A. Hoydu, A. Hubbard, J. Rychik, M. Jacobs, K. E. Fellows, and J. Haselgrove THE NATURE OF FLOW IN THE SYSTEMIC VENOUS PATHWAY MEASURED BY MAGNETIC RESONANCE BLOOD TAGGING IN PATIENTS HAVING THE FONTAN OPERATION J. Thorac. Cardiovasc. Surg., December 1, 1997; 114(6): 1032 - 1041. [Abstract] [Full Text]
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M. Jahangiri, D. Shore, V. Kakkar, C. Lincoln, and E. Shinebourne COAGULATION FACTOR ABNORMALITIES AFTER THE FONTAN PROCEDURE AND ITS MODIFICATIONS J. Thorac. Cardiovasc. Surg., June 1, 1997; 113(6): 989 - 993. [Abstract] [Full Text]
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D. B. McElhinney, V. M. Reddy, P. Moore, and F. L. Hanley Revision of Previous Fontan Connections to Extracardiac or Intraatrial Conduit Cavopulmonary Anastomosis Ann. Thorac. Surg., November 1, 1996; 62(5): 1276 - 1282. [Abstract] [Full Text]
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R. Kaulitz, G. Ziemer, I. Luhmer, and H.-C. Kallfelz MODIFIED FONTAN OPERATION IN FUNCTIONALLY UNIVENTRICULAR HEARTS: PREOPERATIVE RISK FACTORS AND INTERMEDIATE RESULTS J. Thorac. Cardiovasc. Surg., September 1, 1996; 112(3): 658 - 664. [Abstract] [Full Text]
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 J. W. Moore Should Fontan FenestrationsBe Closed With Coils? Circulation, August 1, 1996; 94(3): 247 - 248. [Full Text]
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