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Sequelae after modified Fontan operation: postoperative haemodynamic data and organ function

R Kaulitz1, I Luhmer, F Bergmann

  • 1Department of Paediatric Cardiology, Children's Hospital, Hannover Medical School, Germany.

Heart (British Cardiac Society)
|August 1, 1997
PubMed
Summary
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The Fontan operation can lead to elevated systemic venous pressure and abnormal lab findings, even in asymptomatic patients. Regular organ function evaluation is crucial for early detection of potential complications.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • The Fontan operation is a palliative procedure for functionally univentricular hearts.
  • Elevated systemic venous pressure is a known complication, but its specific sequelae require further investigation.

Purpose of the Study:

  • To investigate the specific sequelae of the Fontan operation.
  • To particularly examine the potential sequelae of chronically elevated systemic venous pressure.

Main Methods:

  • Retrospective analysis of clinical and hemodynamic data in 80 patients post-Fontan operation.
  • Evaluation of organ function, including liver function tests and coagulation profiles.
  • Follow-up ranged from 12 to 106 months, with cardiac catheterization in 62 patients.

Related Experiment Videos

Main Results:

  • Older age at operation correlated with higher systemic venous pressure and lower cardiac index.
  • Abnormal laboratory findings were common, including atrial arrhythmia (17%), protein-losing enteropathy (2.5%), hypoproteinemia (12.5%), mild cholestasis (30%), and atrial thrombosis (6.2%).
  • Protein C deficiency was noted in 25% of patients, with signs of coagulation activation in 9%.

Conclusions:

  • A significant proportion of clinically asymptomatic patients exhibit abnormal laboratory findings mid-term after Fontan operation.
  • Detailed organ function evaluation is essential for early detection of complications.
  • Proactive diagnostic procedures are necessary before clinical symptoms manifest.