The nonfenestrated extracardiac Fontan procedure: a cohort of 145 patients.

Creator(s)

James E. O'Brien, Children's Mercy HospitalFollow
Jennifer A. Marshall, Children's Mercy HospitalFollow
Anne R. Young, Children's Mercy Hospital
Kristina M. Handley, Children's Mercy Hospital
Gary K. Lofland, Children's Mercy Hospital

Document Type

Article

Publication Date

6-2010

Identifier

DOI: 10.1016/j.athoracsur.2010.02.055

Abstract

BACKGROUND: There are limited data available on the outcomes of single-ventricle patients who have undergone a nonfenestrated extracardiac Fontan procedure. This study examined the clinical experience of a large cohort of patients from a single institution who received this procedure.

METHODS: A retrospective data set of 145 patients who underwent a nonfenestrated extracardiac Fontan procedure from July 1997 to September 2008 was reviewed.

RESULTS: The hospital survival was 94.5%. Takedown of the Fontan conduit was necessary in 4 patients (2.8%), and 3 of these 4 patients were also operative deaths. Although female sex (p = 0.048), cardiopulmonary bypass time (p = 0.002), and aortic cross-clamp time (p = 0.007) were found to be significant in the univariate analysis, only sex (p = 0.035; odds ratio, 3.869; 95% confidence limits, 1.097 to 13.644) and cardiopulmonary bypass time in minutes (p = 0.001; odds ratio, 1.023; 95% confidence limits, 1.009 to 1.037) were found to be significant in the multivariate analysis for hospital survival. The late survival was 95.6% (131 of 137 patients) with a mean follow-up of 3.3 years (range, 0.0 to 10.8 years). The freedom from Fontan failure was 92% at 1 year, 89% at 5 years, and 82% at 10 years. Stepwise logistic regression found cardiopulmonary bypass time (p = 0.003; odds ratio, 1.023; 95% confidence limits, 1.008 to 1.039) to be a significant risk factor for late survival.

CONCLUSIONS: The nonfenestrated extracardiac Fontan procedure can be successfully used in the palliation of single-ventricle patients.

Journal Title

The Annals of thoracic surgery

Volume

89

Issue

6

First Page

1815

Last Page

1820

MeSH Keywords

Child, Preschool; Female; Fontan Procedure; Heart Defects, Congenital; Humans; Male; Postoperative Complications; Retrospective Studies; Risk Factors; Survival Rate

Keywords

Fontan Procedure; Congenital Heart Defects; Postoperative Complications; Retrospective Studies; Risk Factors; Survival Rate

Recommended Citation

O'Brien, J. E., Marshall, J. A., Young, A. R., Handley, K. M., Lofland, G. K. The nonfenestrated extracardiac Fontan procedure: a cohort of 145 patients. The Annals of thoracic surgery 89, 1815-1820 (2010).