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Long-term results after Fontan procedure and its modifications
Summary
The Fontan procedure effectively treats complex heart conditions like tricuspid atresia and univentricular heart. Modified techniques significantly reduced early mortality and maintained good clinical outcomes for patients.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Congenital Heart Disease
Background:
- The Fontan procedure is a palliative surgical treatment for complex congenital heart defects.
- Modifications aim to improve outcomes for patients with conditions such as tricuspid atresia and univentricular heart.
Observation:
- This study analyzed 35 Fontan operations performed between 1975 and 1984 on 31 patients (ages 4-26).
- Early mortality decreased from 30% to 12% after modifying the operative technique.
Findings:
- Postoperative catheterization showed excellent results in 15 of 20 patients.
- Reduced oxygen saturation occurred in five patients, with reoperations needed for conduit issues or anatomical anomalies.
- Mean right atrial pressure ranged from 10-20 mm Hg, with normal systemic ventricular function.
Implications:
- The Fontan procedure, despite inactivating right ventricular function, does not adversely affect the systemic ventricle in these complex heart patients.
- Patients exhibit good to excellent clinical status post-procedure, though exercise response may be abnormal.