Fontan operation. Hemodynamic factors associated with postoperative outcomes

The Fontan operation is usually the final palliative procedure in patients with univentricular heart. The objectives of this study were, firstly, to describe the clinical and haemodynamic characteristics of a group of patients with univentricular physiology who had previously been palliated with a b...

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Bibliographic Details
Published in:Revista española de cardiología (English ed.) 2012-04, Vol.65 (4), p.356-362
Main Authors: Mendoza, Alberto, Albert, Leticia, Ruiz, Enrique, Boni, Lorenzo, Ramos, Victoria, Velasco, Jose M, Herrera, Dolores, Granados, Miguel A, Comas, Juan V, Perez, Ana
Format: Article
Language:English
Subjects:
Cardiac Catheterization
Cardiopulmonary Bypass
Child
Child, Preschool
Female
Follow-Up Studies
Fontan Procedure
Heart Defects, Congenital - surgery
Hemodynamics - physiology
Hospital Mortality
Humans
Male
Postoperative Period
Retrospective Studies
Risk Factors
Survival Analysis
Treatment Outcome
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Summary:The Fontan operation is usually the final palliative procedure in patients with univentricular heart. The objectives of this study were, firstly, to describe the clinical and haemodynamic characteristics of a group of patients with univentricular physiology who had previously been palliated with a bidirectional Glenn procedure and, secondly, to identify risk factors that can influence postoperative outcomes after the Fontan operation. Retrospective study with 32 patients who underwent a Fontan operation between March 2000 and December 2009. Clinical characteristics, catheterization data, type and duration of surgery were revised and analyzed as predictors of postoperative outcome. Hospital mortality was 3%. After a median follow-up of 44 months (interquartile range, 32-79), survival was 90%. Preoperative mean pulmonary artery pressure (measured during catheterization) was correlated with late mortality. Of the remaining variables analyzed, the Nakata and McGoon indices, and duration of cardiopulmonary bypass showed the highest correlations with postoperative outcomes. Interventional catheterization before the Fontan operation was performed in 42% of patients. Hospital mortality after the Fontan operation was very low. The performance of a haemodynamic study before the Fontan operation made it possible to select high-risk patients for surgery as well as permitting the performance of interventional procedures that could improve postoperative outcome in these patients.
ISSN:1885-5857
DOI:10.1016/j.recesp.2011.11.018