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Related Experiment Videos

The Fontan procedure in adults

R N Gates1, H Laks, D C Drinkwater

  • 1Department of Surgery, University of California, Los Angeles, School of Medicine, 90095-1741, USA.

The Annals of Thoracic Surgery
|April 1, 1997
PubMed
Summary

Adults undergoing the Fontan procedure experienced low operative mortality and morbidity. Careful follow-up is essential due to late arrhythmias and potential reoperations in these Fontan patients.

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Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Adult Congenital Heart Disease

Background:

  • The Fontan procedure is a palliative surgical option for complex single-ventricle congenital heart disease.
  • Adults undergoing this procedure represent a growing population with unique long-term management challenges.

Observation:

  • This study evaluated 21 adults (18-40 years) who underwent the Fontan procedure between 1982 and 1994.
  • Preoperative risk factors included elevated left ventricular end-diastolic pressure, reduced ejection fraction, and pulmonary hypertension.

Findings:

  • The operative mortality rate was 5%, with 30% experiencing major complications like prolonged effusions.
  • At a mean follow-up of 7.4 years, New York Heart Association class improved significantly.
  • Late complications included one death (5%) from ventricular arrhythmia, reoperations in 16%, and arrhythmias in 37%.

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Implications:

  • Properly selected adults can achieve favorable outcomes after the Fontan procedure.
  • Long-term surveillance is crucial for managing late-onset arrhythmias, potential reoperations, and declining ventricular function in Fontan survivors.