Fontan operation and the cavopulmonary technique: immediate and late results according to the presence of atrial fenestration

• Published in: Arquivos brasileiros de cardiologia 2002-02, Vol.78 (2), p.162-166
• Main Authors: Atik, Edmar, Ikari, Nana Miura, Martins, Tamara Cortez, Barbero-Marcial, Miguel
• Format: Article
• Language: English
• Subjects: CARDIAC & CARDIOVASCULAR SYSTEMS; cavopulmonary anastomosis; Child; Female; fenestration; Follow-Up Studies; Fontan Procedure - methods; Fontan Procedure - mortality; Fontan technique; Heart Atria - abnormalities; Heart Atria - surgery; Heart Bypass, Right - methods; Heart Bypass, Right - mortality; Heart Defects, Congenital - mortality; Heart Defects, Congenital - surgery; Humans; Male; Pericardial Effusion - etiology; Pleural Effusion - etiology; Postoperative Complications - etiology; Postoperative Complications - mortality; Treatment Outcome
• ISSN: 0066-782X; 1678-4170; 0066-782X; 1678-4170
• DOI: 10.1590/S0066-782X2002000200004

To compare immediate and late results in patients with or without fenestration who underwent cavopulmonary anastomosis so that we could assess the efficiency of the technique. Sixty-two patients underwent surgery between 1988 and 1999, 41 with fenestration (group I -G I) and 21 without fenestration (group II -G II). Tricuspid atresia was prevalent in group I (23-56%) and single ventricle was prevalent in group II (14-66%). Mean ages at the time of operation were 7.3 years in group I and 7.6 in group II. At late follow-up, mean ages were 10.6 years in group I and 12.8 years in group II. Immediate and late mortality were 7.3% in G-I and 4.7% in G-II. Significant pleural effusion occurred in 41.4% of G-I patients and in 23.8% of G-II patients. Significant pericardial effusion occurred in 29.2% and 14.2%, respectively, in groups I and II. Central venous pressure was greater in G-II, 17.7 cm in H2O, as opposed to 15 cm in G-I. Hospital stay was similar between the groups, 26.3 and 21.8 days, respectively. Cyanosis and arterial insaturation occurred in 5 patients, and 4 patients were in functional class II, all from G-I. At late follow-up, 58 (93.5%) were in functional class I. Sinus rhythm was present in 94%, and pulmonary perfusion was similar in both groups. Eleven patients who underwent spirometry had good tolerance to physical effort. Atrial fenestration did not improve the immediate or late follow-up of patients who underwent cavopulmonary anastomosis, and is, therefore, dispensable.