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Successful modified Fontan procedure in an adolescent after left pneumonectomy
D Danilowicz1, A Langsner, S B Colvin
1Department of Pediatrics, New York University Medical Center, New York.
Pediatric Cardiology
|July 1, 1991
Summary
A modified Fontan anastomosis successfully replaced a Waterston anastomosis in a patient with tricuspid atresia, maintaining satisfactory function after pneumonectomy for hemoptysis.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Congenital Heart Disease
Background:
- Tricuspid atresia is a severe congenital heart defect requiring surgical palliation.
- Waterston anastomosis is a surgical technique used in some palliative procedures.
- Massive idiopathic hemoptysis can complicate cardiac conditions, necessitating interventions like pneumonectomy.
Observation:
- A patient with complicated tricuspid atresia underwent a Waterston anastomosis at two months of age.
- At 14 years, the patient required a left pneumonectomy due to massive idiopathic hemoptysis.
- Four months post-pneumonectomy, a modified Fontan anastomosis was performed to replace the Waterston anastomosis.
Findings:
- Restudy at 17 years of age demonstrated continued satisfactory cardiac function following the modified Fontan procedure.
- The surgical revision effectively managed the complications arising from the initial palliative surgery and subsequent pneumonectomy.
Implications:
- This case highlights the potential for successful revision of palliative cardiac surgeries in complex pediatric cases.
- Modified Fontan anastomosis can serve as a viable alternative to earlier palliative techniques when complications arise.
- Long-term follow-up is crucial for patients with congenital heart disease undergoing multiple surgical interventions.