[Risk factors in Fontan's operation]

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology

Context:

• The Fontan procedure is a palliative surgical option for complex congenital heart disease.
• Optimizing outcomes in Fontan patients requires careful consideration of pre-operative and intra-operative factors.

Purpose:

• To analyze the outcomes of the Fontan procedure in 51 patients with congenital heart defects.
• To identify risk factors associated with adverse outcomes and determine optimal surgical techniques.

Summary:

• Risk factors for poor outcomes include high total lung resistance (>4 mu/m2), low arterial ventricular ejection fraction (<55%), severe concomitant heart defects, and extensive surgical interventions.
• Valveless atriopulmonary anastomosis yielded the best results, while right atrium-pulmonary trunk anastomosis with a valve was associated with the poorest outcomes.

Impact:

• Identifies key risk factors to guide patient selection and surgical planning for the Fontan procedure.
• Highlights the importance of specific anastomotic techniques for improving Fontan procedure success rates.