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[Fontan's operation: results, immediate and long-term postoperative complications]
P Austoni1, M Spata, T Varisco
1Dipartimento Cardiologico A. De Gasperis, Ospedale Niguarda-Ca' Granda, Milano.
Giornale Italiano Di Cardiologia
|August 1, 1990
Summary
The Fontan operation is a safe treatment for complex congenital heart disease, with few hospital deaths. Postoperative complications like venous stasis and pleural effusion are linked to higher right atrial pressure.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
Background:
- Complex congenital heart diseases, including univentricular heart and tricuspid atresia, often require palliative surgical interventions.
- The Fontan operation is a key procedure for managing these conditions, but it carries risks of postoperative complications.
Purpose of the Study:
- To investigate the main postoperative complications following the Fontan procedure.
- To identify incremental risk factors associated with the development of these complications.
Main Methods:
- Retrospective review of 11 patients who underwent the Fontan operation between January 1984 and January 1988.
- Analysis of postoperative outcomes, including Intensive Care Unit stay, re-operations, signs of venous stasis, and long-term follow-up.
- Correlation of complication rates with postoperative mean right atrial pressure and Nakata index values.
Main Results:
- No hospital deaths occurred among the 11 patients.
- Significant signs of venous stasis (hepatomegaly, pleural effusion) were observed in 8 patients.
- Postoperative mean right atrial pressure > 15 mmHg correlated with increased short- and medium-term complication rates and was associated with Nakata index < 250 mm²/m².
Conclusions:
- The Fontan operation demonstrates excellent survival and functional recovery rates.
- Elevated postoperative mean right atrial pressure is a key risk factor for complications.
- Careful monitoring of right atrial pressure and Nakata index may aid in risk stratification.