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Related Experiment Videos

Total cavopulmonary connection to one lung.

Marshall L Jacobs1, Douglas J Schneider, Kamal K Pourmoghadam

  • 1Sections of Cardiothoracic Surgery' and Cardiology, St Christopher's Hospital for Children, Philadelphia, PA 19134, USA.

Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
|July 31, 2004
PubMed
Summary

Modified Fontan operations can be successful even with single pulmonary artery. Hemodynamic parameters predict survival, but protein-losing enteropathy may increase.

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Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Congenital Heart Disease

Background:

  • Pulmonary circulation is critical for modified Fontan operation success.
  • Pulmonary artery issues like distortion, hypoplasia, and high resistance are risk factors.
  • Irreparable single pulmonary artery necessitates considering single-lung Fontan operations.

Purpose of the Study:

  • To evaluate the outcomes of modified Fontan operations performed with only one functioning pulmonary artery.
  • To determine if standard hemodynamic parameters predict survival in single-lung Fontan cases.
  • To assess potential complications, such as protein-losing enteropathy, in this patient group.

Main Methods:

  • Retrospective review of 12 cases undergoing modified Fontan operation to a single pulmonary artery.

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  • Analysis of standard hemodynamic parameters including pulmonary artery pressure and flow, ventricular end-diastolic pressure, transpulmonary gradient, and pulmonary vascular resistance.
  • Comparison of outcomes and complication rates with historical data for patients with normal pulmonary vascular beds.

    • Main Results:

    • No operative mortalities were observed in the 12 cases.
    • All patients met standard criteria for hemodynamic acceptability.
    • A potential for increased incidence of protein-losing enteropathy was noted compared to patients with normal pulmonary vascular beds.

    Conclusions:

    • Modified Fontan operation to a single pulmonary artery can achieve satisfactory outcomes.
    • Hemodynamic parameters remain key predictors of operative survival.
    • Efforts to preserve or restore pulmonary vascular bed capacity are crucial, but a single pulmonary artery does not preclude success.