[Long-term results of Fontan type operation]

We had experienced 41 Fontan type operations between 1977 and 2002. Twelve patients had an atriopulmonary connection (APC), 3 patients had a lateral tunnel connection, and 2 had internal conduit repair and 24 patients received an external conduit repair. There were 3 operative deaths and 5 late deaths (5 months to 24 years). Kaplan-Meier analysis shows good 5-years survival in both group of atriopulmonary connection and that of total cavoplumonary connection (TCPC). However, survival and clinical status of APC patients deteriorated after 7 years. Atrial fibrillation and right pulmonary vein stenosis by giant right atrium become common in these patients. We recommend that patients with single ventricle have the TCPC type operation and patients with giant right atrium and poor clinical status after APC have the TCPC conversion.