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[Fenestrated Fontan surgery in high risk patients]
S Ramírez Marroquín1, J Calderón Colmenero, R Lince Varela
1Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Archivos Del Instituto De Cardiologia De Mexico
|June 12, 1999
Summary
The fenestrated Fontan procedure is a useful option for children with single ventricle congenital heart disease and risk factors. This study found a 23% mortality rate, with nonsurvivors having multiple risk factors.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Surgery
- Cardiovascular Surgery
Background:
- The Fontan procedure is a palliative treatment for complex congenital heart disease.
- Fenestration is a modification to improve outcomes in select patients.
- Risk factors influence Fontan procedure success.
Purpose of the Study:
- To evaluate the outcomes of the fenestrated Fontan procedure.
- To identify risk factors associated with mortality and complications.
- To assess the utility of fenestration in high-risk patients.
Main Methods:
- Retrospective analysis of patients undergoing fenestrated Fontan procedure (January 1990 - May 1996).
- Inclusion criteria based on specific hemodynamic and anatomical risk factors.
- Analysis of pre-operative risk factors, post-operative outcomes, and mortality.
Main Results:
- Overall mortality was 23%.
- Nonsurvivors presented with two to four risk factors.
- Complications included protein-losing enteropathy and stroke; mean pleural effusion duration was 16 days.
Conclusions:
- Fenestrated Fontan procedure is considered useful for patients with single ventricle congenital heart disease and risk factors.
- The presence of multiple risk factors is associated with increased mortality.
- Careful patient selection is crucial for optimizing outcomes.
