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[Total cavo-pulmonary bypass. Short-term results]
L Houyel1, J Petit, J Bruniaux
1Centre chirurgical Marie-Lannelongue, université Paris-Sud, Le Plessis-Robinson.
Archives Des Maladies Du Coeur Et Des Vaisseaux
|May 1, 1992
Summary
This study compared two total cavopulmonary connection techniques for complex congenital heart disease. High right heart pressures and atrioventricular valve issues were key factors impacting outcomes in Fontan procedure patients.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Congenital Heart Disease
Context:
- The Fontan procedure is a palliative surgery for complex cyanotic congenital heart disease.
- Complications associated with the Fontan procedure necessitate the evaluation of surgical techniques.
- This study focuses on total cavopulmonary connection using a right intra-atrial baffle (Pugas' technique) and a modified de Kreutzer technique.
Purpose:
- To assess and compare the outcomes of two total cavopulmonary connection techniques.
- To identify risk factors influencing postoperative complications and mortality in patients undergoing the Fontan procedure.
Summary:
- Thirty-eight patients with complex cyanotic congenital heart disease underwent either Pugas' technique or the modified de Kreutzer technique for total cavopulmonary connection.
- The overall mortality rate was 15.8%, with 10.5% in the operative period, often related to high right heart pressures.
- Poor prognostic factors included atresia/hypoplasia of the systemic atrioventricular valve and previous banding, associated with increased mortality and reoperation rates, respectively.
Impact:
- Identifies critical risk factors (atrioventricular valve status, prior banding) that significantly influence Fontan procedure outcomes.
- Highlights the challenges of managing high right heart pressures post-Fontan procedure, contributing to mortality.
- Provides insights for surgical decision-making and patient selection in complex congenital heart disease management.