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

This Article Full Text Alert me when this article is cited Alert me if a correction is posted 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 Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Search for Related Content Related Collections Related Article

Ann Thorac Surg 1996;62:461-462
© 1996 The Society of Thoracic Surgeons

---

Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 456.

DR FRANCISCO J. PUGA (Rochester, MN): This is a very excellent presentation and a very considerable experience on a difficult subject. I congratulate you for your excellent results. I have one question. Did I understand correctly that you propose interruption of any other source of pulmonary blood flow at the time of performance of the hemi-Fontan or bidirectional Glenn procedure? If that is the case, have you seen any patients in whom pulmonary arteriovenous fistulas have appeared? We have seen some of this in our experience, and we have also seen development of extensive systemic-to-pulmonary collaterals that may actually interfere with the performance of the Fontan procedure later on.

DR JACOBS: Yes, I think that is a very appropriate question. The interval between hemi-Fontan and completion Fontan operation for the majority of these patients is on the order of 12 months. We have not seen in this group of patients evidence of important intrapulmonary arteriovenous fistulas. There are a few outliers who, on the basis of social reasons or reasons of referral, are now 3 or 3 years out after the hemi-Fontan operation and awaiting reevaluation before completion, and I think we will have to look very critically to see if there is any evidence of arteriovenous fistula formation in that group.

DR CARLO MARCELLETTI (Rome, Italy): I enjoyed very much the presentation of such extensive experience. I would like to reinforce the observation that Dr Puga has made. Excluding hypoplastic left heart syndrome, for all other congenital anomalies . . . [Full Text of this Article]

Related Article

Early Reduction of the Volume Work of the Single Ventricle: The Hemi-Fontan Operation

Marshall L. Jacobs, Jack Rychik, Jonathan J. Rome, Sotiria Apostolopoulou, Christian Pizarro, John D. Murphy, and William I. Norwood, Jr
Ann. Thorac. Surg. 1996 62: 456-461. [Abstract] [Full Text]

This article has been cited by other articles:

				S. B. O'Blenes, S. L. Merklinger, A. Jegatheeswaran, A. Campbell, M. Rabinovitch, I. Rebeyka, and G. Van Arsdell Low Molecular Weight Heparin and Unfractionated Heparin Are Both Effective at Accelerating Pulmonary Vascular Maturation in Neonatal Rabbits Circulation, September 9, 2003; 108(90101): II-161 - 166. [Abstract] [Full Text] [PDF]