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Related Experiment Videos

Fontan completion in infants.

Christian Pizarro1, Tomasz Mroczek, Samuel S Gidding

  • 1Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA. cpizarro@nemours.org

The Annals of Thoracic Surgery
|May 30, 2006
PubMed
Summary

Fontan completion outcomes were analyzed, revealing that while generally successful in infants, noncardiac conditions and high pulmonary artery pressure predict poorer results. Hypoplastic left heart syndrome specifically correlates with prolonged effusions.

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Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease Surgery
  • Outcomes Research

Background:

  • The Fontan procedure is a critical palliative surgery for complex congenital heart defects.
  • Identifying factors influencing outcomes after Fontan completion is essential for improving patient care.

Purpose of the Study:

  • To evaluate outcomes following Fontan completion surgery.
  • To identify predictors of adverse events, including early mortality, prolonged effusions, and extended hospital stays.
  • To specifically assess the impact of age and cardiac diagnosis on Fontan completion outcomes.

Main Methods:

  • A retrospective review of 107 patients who underwent Fontan completion between January 1998 and July 2005.
  • Analysis of clinical factors, including age, cardiac diagnosis, transpulmonary gradient, and pulmonary artery pressure.

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  • Statistical analysis to identify variables associated with poor outcomes.

    • Main Results:

    • Hypoplastic left heart syndrome (HLHS) was present in 61 patients; 69 had initial Norwood palliation.
    • Overall mortality was 4.5%. Variables linked to poor outcomes included noncardiac diagnoses (p < 0.05), elevated transpulmonary gradient (p = 0.03), and pulmonary artery pressure (p < 0.02).
    • HLHS was uniquely associated with prolonged effusive complications.

    Conclusions:

    • Fontan completion in the first year of life yields good results, irrespective of the specific cardiac diagnosis.
    • Significant noncardiac pathology and elevated pulmonary artery pressure are key predictors of worse outcomes.
    • Patients with hypoplastic left heart syndrome are more prone to prolonged effusions post-Fontan completion.