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Ventricular exclusion during Fontan operation: an evolving technique.

R di Donato, A E Becker, A Nijveld

The Annals of Thoracic Surgery

|March 1, 1985

Summary

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This study evaluated two methods for the modified Fontan operation to exclude the ventricle. Patch implantation into the atrial wall provided more permanent occlusion than suturing into valve leaflets, avoiding complications.

Area of Science:

Cardiac Surgery
Pediatric Cardiology
Congenital Heart Disease

Background:

The modified Fontan operation requires reliable ventricular exclusion.
Preserving atrioventricular conduction is critical during this procedure.

Purpose of the Study:

To compare two surgical techniques for right atrioventricular ostium obliteration in the modified Fontan operation.
To assess the safety and efficacy of each technique in preventing heart block and ensuring permanent occlusion.

Main Methods:

Ten patients underwent a modified Fontan operation with ventricular exclusion.
Two methods were used for occlusion: suturing a patch into valve leaflets (5 patients) or into the right atrial wall (5 patients).

Main Results:

Related Experiment Videos

No patients experienced postoperative heart block with either technique.
Three cases of late patch dehiscence occurred exclusively in the group where the patch was sutured into the valve leaflets.
Patch implantation into the atrial wall demonstrated superior permanence of occlusion.

Conclusions:

Both techniques are safe for preserving the atrioventricular node and bundle.
Implanting the patch into the atrial wall is preferred for achieving permanent occlusion in modified Fontan operations.
The atrial wall patching technique is recommended for improved long-term outcomes.