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Related Experiment Videos

Early experience with extracardiac Fontan operation.

V Alexi-Meskishvili1, S Ovroutski, I Dähnert

  • 1Department of Cardiovascular Surgery, German Heart Institute Berlin. alexi@dhzb.de

The Annals of Thoracic Surgery
|February 24, 2001
PubMed
Summary

The extracardiac Fontan (ECFO) operation, when performed without cardioplegia, shows promising early results. This approach may reduce complications and recovery time in pediatric patients.

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Area of Science:

  • Pediatric Cardiac Surgery
  • Congenital Heart Disease Management
  • Cardiopulmonary Bypass Techniques

Background:

  • The extracardiac Fontan (ECFO) operation has become increasingly prevalent in the last decade.
  • This study evaluates the initial clinical experience with the ECFO procedure.

Purpose of the Study:

  • To analyze the early outcomes of the extracardiac Fontan operation.
  • To compare the results of ECFO performed with and without cardioplegia.

Main Methods:

  • Thirty-three pediatric patients underwent ECFO, with a median age of 4.1 years.
  • Normothermic perfusion with a beating heart was used in 24 patients.
  • Cardioplegia was used in 7 patients; fenestration was omitted in the final 16 patients operated on without cardioplegia.

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Main Results:

  • Hospital mortality was 6% (2 patients).
  • Patients operated on without cardioplegia experienced shorter inotropic support, mechanical ventilation, ICU and hospital stays, and fewer prolonged pleural effusions.
  • The complication rate was lower in the group that did not receive cardioplegia.

Conclusions:

  • ECFO can be safely performed using normothermic cardiopulmonary bypass without cardioplegia or fenestration.
  • Omitting cardioplegia appears to reduce postoperative morbidity and early arrhythmias.
  • Longer follow-up is required to confirm the long-term benefits of this approach.