HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Shuichi Shiraishi Toshikatsu Yagihara Ikuo Hagino Junjiro Kobayashi Soichiro Kitamura Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Shiraishi, S. Articles by Kitamura, S. Search for Related Content PubMed Articles by Shiraishi, S. Articles by Kitamura, S. Related Collections Congenital - cyanotic

---

Original Articles: Pediatric Cardiac

Impact of Age at Fontan Completion on Postoperative Hemodynamics and Long-Term Aerobic Exercise Capacity in Patients With Dominant Left Ventricle

^a Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan
^b Department of Pediatrics, National Cardiovascular Center, Osaka, Japan

Accepted for publication November 12, 2008.

^_* Address correspondence to Dr Yagihara, Department of Cardiovascular Surgery, National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan (Email: yagihara{at}hsp.ncvc.go.jp).

Presented at the Forty-fourth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 28–30, 2008.

Background: Although the Fontan procedure is now being applied to younger patients, the influence of patients' age at the time of surgery on long-term results remains unclear. We investigated whether age at Fontan completion affects subsequent hemodynamics and exercise capacity in patients with a dominant left ventricle followed up for more than 5 years.

Methods: Between January 1990 and December 2001, 68 patients with a dominant left ventricle underwent total cavopulmonary connection (TCPC) at our institute. The survivors routinely underwent postoperative exercise tests and catheterization at 1 year and then every 5 years after TCPC, and were divided into group A (<3 years; n = 32) and group B (3 years; n = 33), according to age at time of the Fontan procedure and retrospectively reviewed. We also examined the correlation between age at Fontan and data from postoperative catheterization or exercise tests.

Results: None of the patients died during a follow-up period of 91.2 ± 46.7 months. The postoperative exercise capacity (peak oxygen consumption; % of normal [61.3 ± 11.5 versus 51.9 ± 9.1, p = 0.0001]), cardiac index () at 5 years (3.31 ± 0.62 versus 2.86 ± 0.69, p = 0.0133) and at 10 years after TCPC (3.24 ± 0.46 versus 2.61 ± 0.65, p = 0.0194), and ventricular ejection fraction (%) at 10 years after TCPC (62.1 ± 7.6 versus 53.0 ± 8.0, p = 0.0131) were significantly higher in group A. Age at Fontan completion inversely correlated with postoperative peak oxygen consumption (R = –0.374, p = 0.0006) and cardiac index at 5 years (R = –0.452, p = 0.0003) and 10 years after TCPC (R = –0.491, p = 0.0072).

Conclusions: Earlier TCPC is beneficial in the long term from the viewpoint of exercise capacity and hemodynamics among patients with a dominant left ventricle.