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Fontan Completion for Younger than 3 Years of Age: Outcome in Patients with Functional Single Ventricle

Laurynas Bezuska1, Virgilijus Lebetkevicius2,3, Kestutis Lankutis3

  • 1Department of Cardiovascular Medicine, Vilnius University, Santariskiu 2, 08661, Vilnius, Lithuania. laurynas.bezuska@santa.lt.

Pediatric Cardiology
|June 25, 2015
PubMed

Insights

Performing the Fontan procedure earlier in single ventricle patients may reduce chest drain duration. This study compared outcomes in children under and over 36 months, finding earlier surgery potentially beneficial.

Area of Science:

  • Pediatric Cardiac Surgery
  • Congenital Heart Disease
  • Single Ventricle Physiology

Background:

  • The Fontan procedure is a palliative surgery for single ventricle congenital heart defects.
  • Optimal timing for Fontan completion after staged palliation remains debated.
  • Early Fontan completion is increasingly common but requires careful consideration of outcomes.

Purpose of the Study:

  • To evaluate the outcomes of extracardiac total cavopulmonary connection (TCPC) in children undergoing the Fontan procedure at different ages.
  • To compare results between patients younger than 36 months (Group A) and those 36 months or older (Group B).

Main Methods:

  • Retrospective review of 45 patients with functional single ventricle who underwent extracardiac TCPC between 2000 and 2013.
  • Patients were divided into Group A (age < 36 months) and Group B (age ≥ 36 months).
  • Data analyzed included hospital stay, intensive care unit stay, mortality, and chest drain duration.

Main Results:

  • Overall mortality was low, with no significant difference between groups (p=0.286).
  • Group A (younger patients) had a significantly shorter chest drain stay (median 12 days) compared to Group B (median 22 days) (p=0.014).
  • Intensive care unit and hospital stay durations showed no significant difference between the groups.

Conclusions:

  • Extracardiac TCPC can be performed in younger children (<36 months) with favorable intermediate outcomes.
  • Earlier Fontan completion may be associated with reduced chest drain duration, suggesting potential advantages.
  • Further research is warranted to confirm long-term benefits of early Fontan completion.

Keywords:
Cavopulmonary connectionFontan conversionGORE-TEX® conduitSingle ventricle

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