| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1995;59:433-437
© 1995 The Society of Thoracic Surgeons
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan
Accepted for publication October 6, 1994.
Between November 1987 and January 1990, 33 patients (tricuspid atresia, 9 patients; mitral atresia, 3; single ventricle, 15; others, 6) underwent Fontan operations. The rate of blood flow returning to the heart during aortic cross-clamping was measured as an indication of the extent of development of aortopulmonary collateral arteries. Percent cardiac return (calculated by dividing the blood flow rate returning to the heart by the cardiopulmonary bypass blood flow rate and expressing the value as a percentage), were 1% to 9%, 7 patients; 10% to 19%, 11; 20% to 29%, 9; 30% to 39%, 4; 40% to 49%, 1; and 50% to 59%, 1 patient. Percent cardiac return showed a significant correlation with postoperative mean systemic venous pressure (r = 0.6, p < 0.01). In those patients in whom percent cardiac return was more than 33%, the mean systemic venous pressure after operation was high (more than 17 mm Hg), and none of these patients survived. To predict percent cardiac return preoperatively, the conventional indices of systemic ventricular volume, pulmonary artery area index, arterial blood oxygen saturation, pulmonary blood flow index, and pulmonary vascular resistance were analyzed. None of these showed significant correlation with percent cardiac return. However, all the patients who had a high percent cardiac return (more than 30%) also had both high arterial blood oxygen saturation (more than 75% in room air) and small pulmonary artery area index (less than 55%). In addition, the age at operation showed good correlation (r = 0.6, p < 0.01) to percent cardiac return. We conclude that high percent cardiac return is one of the risk factors for Fontan operations and can be predicted preoperatively, even if the collateral arteries are not always visible on angiography. If aortopulmonary collaterals are visible on angiography, it is suggested that their preoperative embolization may decrease percent cardiac return and hence operative risk.
This article has been cited by other articles:
|
|
 |
|
  A. J. Powell Aortopulmonary Collaterals in Single-Ventricle Congenital Heart Disease: How Much Do They Count? Circ Cardiovasc Imaging, May 1, 2009; 2(3): 171 - 173. [Full Text] [PDF]
|
|
|
|
|
|
L. Grosse-Wortmann, A. Al-Otay, and S.-J. Yoo Aortopulmonary Collaterals After Bidirectional Cavopulmonary Connection or Fontan Completion: Quantification With MRI Circ Cardiovasc Imaging, May 1, 2009; 2(3): 219 - 225. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Januszewska, A. Stebel, and E. Malec Consequences of Right Ventricle to Pulmonary Artery Shunt at the First Stage for the Fontan Operation Ann. Thorac. Surg., November 1, 2007; 84(5): 1611 - 1617. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Koh, T. Yagihara, H. Uemura, K. Kagisaki, I. Hagino, T. Ishizaka, and S. Kitamura Intermediate Results of the Double-Switch Operations for Atrioventricular Discordance Ann. Thorac. Surg., February 1, 2006; 81(2): 671 - 677. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. S. Ro, J. Rychik, M. S. Cohen, W. T. Mahle, and J. J. Rome Diagnostic assessment before Fontan operation in patients with bidirectional cavopulmonary anastomosis: Are noninvasive methods sufficient? J. Am. Coll. Cardiol., July 7, 2004; 44(1): 184 - 187. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Sakamoto, H. Kurosawa, T. Shin'oka, M. Aoki, and Y. Isomatsu The influence of pH strategy on cerebral and collateral circulation during hypothermic cardiopulmonary bypass in cyanotic patients with heart disease: Results of a randomized trial and real-time monitoring J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 12 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Ootaki, M. Yamaguchi, N. Yoshimura, S. Oka, M. Yoshida, and T. Hasegawa Vascular endothelial growth factor in children with congenital heart disease Ann. Thorac. Surg., May 1, 2003; 75(5): 1523 - 1526. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Bradley, M. M. McCall, J. J. Sistino, and W. A.K. Radtke Aortopulmonary collateral flow in the Fontan patient: does it matter? Ann. Thorac. Surg., August 1, 2001; 72(2): 408 - 415. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Gaca, W. I. Douglas, and S. D. Barnes Anesthetic Implications of the Fontan Procedure for Single Ventricle Physiology Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2001; 5(1): 31 - 39. [Abstract] [PDF]
|
|
|
|
|
|
R. Aeba, T. Katogi, I. Kashima, T. Omoto, S. Kawada, and K. Omae Factors influencing arterial oxygenation early after bidirectional cavopulmonary shunt without additional sources of pulmonary blood flow J. Thorac. Cardiovasc. Surg., September 1, 2000; 120(3): 589 - 595. [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]
|
|
|
|
 |
|
 H. Uemura, T. Yagihara, Y. Kawahira, Y. Yoshikawa, and S. Kitamura Total cavopulmonary connection in children with body weight less than 10 kg Eur. J. Cardiothorac. Surg., May 1, 2000; 17(5): 543 - 549. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. B. McElhinney, V. M. Reddy, W. Tworetzky, E. Petrossian, F. L. Hanley, and P. Moore Incidence and implications of systemic to pulmonary collaterals after bidirectional cavopulmonary anastomosis Ann. Thorac. Surg., April 1, 2000; 69(4): 1222 - 1228. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Uemura, T. Yagihara, R. Hattori, Y. Kawahira, S. Tsukano, and K. Watanabe Redirection of hepatic venous drainage after total cavopulmonary shunt in left isomerism Ann. Thorac. Surg., November 1, 1999; 68(5): 1731 - 1735. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. R. Kanter, R. N. Vincent, and A. A. Raviele Importance of acquired systemic-to-pulmonary collaterals in the Fontan operation Ann. Thorac. Surg., September 1, 1999; 68(3): 969 - 974. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S A Hope, J Partridge, and Z Slavik A novel use of an Amplatzer septal occluder Heart, June 1, 1999; 81(6): 672 - 673. [Full Text]
|
|
|
|
|
|
R. M. Freedom, D. Nykanen, and L. N. Benson The physiology of the bidirectional cavopulmonary connection Ann. Thorac. Surg., August 1, 1998; 66(2): 664 - 667. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 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]
|
|
| 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 |
