Related Experiment Video
Updated: Sep 27, 2026
Wireless Telemetry Device Implantation in a Fontan Ovine Model for Continuous and Long-Term Hemodynamic Monitoring
Published on: May 2, 2025
Pancreatitis in Fontan patients is related to impaired ventricular relaxation
Aitizaz U Syed1, William L Border, Erik C Michelfelder
1Department of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio 45229-3039, USA.
Insights
Postoperative pancreatitis risk in Fontan patients is linked to impaired ventricular relaxation and reduced cardiac output. Early evaluation of diastolic function may improve outcomes after congenital heart surgery.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Gastroenterology
Background:
- Pancreatitis is a known complication after cardiopulmonary bypass in adults.
- Pancreatitis post-Fontan procedure in pediatric patients is under-recognized.
- Identifying predictors of pancreatitis in Fontan patients is crucial.
Purpose of the Study:
- To identify perioperative factors predicting postoperative pancreatitis in pediatric Fontan patients.
- To analyze hemodynamic and ventricular function parameters in relation to pancreatitis development.
Main Methods:
- Retrospective review of 40 pediatric patients undergoing modified Fontan operation (1996-2001).
- Comparison of 4 patients with postoperative pancreatitis to 10 controls without pancreatitis.
- Analysis of preoperative, intraoperative, and postoperative hemodynamic data, including ventricular relaxation time constant (tau), pulmonary vascular resistance (PVR), and cardiac output (Qs).
Main Results:
- Patients with pancreatitis had a 50% mortality rate versus 0% in controls.
- Significantly prolonged preoperative tau (41 ms vs 26 ms) in the pancreatitis group.
- Lower preoperative systemic output (Qs) in the pancreatitis group (2.75 L/min/m2 vs 5.09 L/min/m2).
Conclusions:
- Impaired ventricular relaxation and decreased preoperative cardiac output predict increased risk of postoperative pancreatitis in Fontan patients.
- Preoperative diastolic function assessment may offer insights into clinical outcomes.
- This study highlights the importance of evaluating ventricular mechanics in Fontan patients.
Background:
Pancreatitis following cardiopulmonary bypass is a well-known complication in adults undergoing cardiac surgery. However, the occurrence of pancreatitis in pediatric patients undergoing repair of congenital heart disease is under-appreciated. Post-Fontan patients are particularly prone to postoperative pancreatitis. In an effort to identify specific perioperative factors predictive of postoperative pancreatitis, we retrospectively reviewed a group of Fontan patients.
Methods:
From June 1996 to June 2001, 40 patients underwent a modified Fontan operation. Four patients developed acute pancreatitis postoperatively. The preoperative, intraoperative, and postoperative hemodynamics and ventricular function parameters were retrospectively analyzed and compared to 10 randomly selected Fontan patients who did not have pancreatitis. Preoperative echocardiographic and angiographic data, including digitized ventricular pressure tracings, were reviewed to obtain ventricular relaxation time constant (tau), pulmonary vascular resistance (PVR), ventricular end diastolic pressure (VEDP), positive dp/dt and negative dp/dt values.
Results:
Patients developing acute pancreatitis had very high mortality (50%) compared to no mortality in the control group. The mean preoperative tau was significantly prolonged (41 ms vs 26 ms in control group, p < 0.001), and pre operative systemic output (Qs) lower in the pancreatitis group (mean 2.75 L/min/m2) compared with controls (Qs of 5.09 L/min/m2, p < 0.03).
Conclusions:
Impaired ventricular relaxation and decreased preoperative cardiac output are predictive of increased risk of postoperative pancreatitis in Fontan patients. Evaluation of preoperative diastolic function in these patients may provide additional insights in to clinical outcome following the Fontan procedure.
Related Concept Videos
01:21Chronic Pancreatitis II: Pathophysiology
01:25Chronic Pancreatitis I: Introduction
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:21Acute Pancreatitis II: Pathophysiology
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include: