ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

 Click here to read this article as a CME activity

Ann Thorac Surg 2009;87:826-831. doi:10.1016/j.athoracsur.2008.10.075
© 2009 The Society of Thoracic Surgeons
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Vladimir Alexi-Meskishvili
Roland Hetzer
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ovroutski, S.
Right arrow Articles by Berger, F.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Ovroutski, S.
Right arrow Articles by Berger, F.
Related Collections
Right arrow Congenital - cyanotic
Right arrowRelated Article

Original Articles: Pediatric Cardiac

Absence of Pulmonary Artery Growth After Fontan Operation and Its Possible Impact on Late Outcome

Stanislav Ovroutski, MDa,*, Peter Ewert, MD, PhDa, Vladimir Alexi-Meskishvili, MD, PhDb, Katinka Hölschera, Oliver Miera, MDa, Björn Peters, MDa, Roland Hetzer, MD, PhDb, Felix Berger, MD, PhDa

a Department of Congenital Heart Diseases, German Heart Institute Berlin, Berlin, Germany
b Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Berlin, Germany

Accepted for publication October 27, 2008.

* Address correspondence to Dr Ovroutski, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, Berlin, 13533, Germany (Email: ovroutski{at}dhzb.de).

Background: The purpose of this study was to evaluate the development of the pulmonary arteries (PAs) after Fontan operation in children at long term.

Methods: Thirty-five patients in whom Fontan operation was performed at median age of 4.2 years (range, 1.5 to 16.1 years) underwent angiographic measurements of the central and lower lobe PA diameter before Fontan operation and during the median follow-up of 4.6 years (range, 1.4 to 15.1 years). The median patient age at follow-up was 8.6 years (range, 3.4 to 27.2 years). Body surface area–dependent PA index and lower lobe index were calculated, and preoperative and follow-up values were compared. A correlation between the PA indices and the duration of the follow-up as well as between PA indices and the outcome was investigated.

Results: Although percentile parallel somatic development of the children could be documented by body surface area measurements (0.62 to 0.93 m2 during the follow-up; p < 0.001), the PA showed no gain in diameter at all. The PA index and lower lobe index (preoperative median, 261 and 138 mm2/m2, respectively) decreased significantly during the follow-up period (median, 177 and 109 mm2/m2;p < 0.001). The lowest PA index was noted in patients who had the longest follow-up (R = 0.5; p = 0.009). We found a correlation between a low PA index and an unfavorable Fontan outcome (n = 10, p = 0.002).

Conclusions: Growth of PAs after Fontan operation is clearly reduced despite somatic growth. This phenomenon may lead to an increase in pulmonary vascular resistance and could be a limit for optimal Fontan circulation in grown children in the long term.


Related Article

Invited Commentary
Kirk Kanter
Ann. Thorac. Surg. 2009 87: 831-832. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
K. Kanter
Invited commentary.
Ann. Thorac. Surg., March 1, 2009; 87(3): 831 - 832.
[Full Text] [PDF]


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
Copyright © 2009 by The Society of Thoracic Surgeons.