PMID- 11514490
OWN - NLM
STAT- MEDLINE
DCOM- 20010920
LR  - 20190503
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 86
IP  - 3
DP  - 2001 Sep
TI  - The Fontan procedure in adults.
PG  - 330-5
AB  - SETTING: Tertiary adult congenital cardiac referral centre. DESIGN: Retrospective 
      cross sectional analysis. OBJECTIVES: To report our 20 year experience with adult 
      Fontan operations, and to compare late outcome in patients with single ventricle 
      with definitive aortopulmonary or cavopulmonary shunt palliation. PATIENTS AND 
      MAIN OUTCOME MEASURES: Patients older than 18 years undergoing Fontan operation 
      between 1 January 1982 and 31 December 1998 were identified. Mortality and late 
      outcome were derived from hospital records. These patients were compared with a 
      cohort of 50 adults with single ventricle who had not undergone a Fontan 
      operation. RESULTS: 61 adults, median age 36 years (range 18-47 years), with a 
      median follow up of 10 years (range 0-21 years) were identified. Actuarial 
      survival was 80% at one year, 76% at five years, 72% at 10 years, and 67% at 15 
      years. Compared with before the Fontan operation, more patients were in New York 
      Heart Association (NYHA) functional class I or II at the latest follow up (80% v 
      58%, p < 0.001). Systolic ventricular function deteriorated during follow up such 
      that 34% had moderate to severe ventricular dysfunction at the latest follow up 
      compared with 5% before Fontan (p < 0.001). Arrhythmia increased with time (10% 
      before Fontan v 57% after 10 years, p < 0.001). Fontan patients had improved NYHA 
      functional class, ventricular function, atrioventricular regurgitation, and fewer 
      arrhythmias than the non-Fontan group at the latest follow up. CONCLUSION: The 
      Fontan operation in adults has acceptable early and late mortality. Functional 
      class, systolic ventricular function, atrioventricular regurgitation, and 
      arrhythmia deteriorate late after surgery but to a lesser degree than in 
      non-Fontan patients with a single ventricle.
FAU - Veldtman, G R
AU  - Veldtman GR
AD  - University of Toronto Congenital Cardiac Centre for Adults, Stroke Ronald Lewar 
      Centre of Excellence, Toronto General Hospital, 200 Elizabeth Street, Toronto, 
      Ontario M5G 2C4, Canada.
FAU - Nishimoto, A
AU  - Nishimoto A
FAU - Siu, S
AU  - Siu S
FAU - Freeman, M
AU  - Freeman M
FAU - Fredriksen, P M
AU  - Fredriksen PM
FAU - Gatzoulis, M A
AU  - Gatzoulis MA
FAU - Williams, W G
AU  - Williams WG
FAU - Webb, G D
AU  - Webb GD
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aortic Valve Insufficiency/etiology
MH  - Arrhythmias, Cardiac/etiology
MH  - Cohort Studies
MH  - Cross-Sectional Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Fontan Procedure/*methods
MH  - Heart Defects, Congenital/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Treatment Outcome
PMC - PMC1729885
EDAT- 2001/08/22 10:00
MHDA- 2001/09/21 10:01
PMCR- 2004/09/01
CRDT- 2001/08/22 10:00
PHST- 2001/08/22 10:00 [pubmed]
PHST- 2001/09/21 10:01 [medline]
PHST- 2001/08/22 10:00 [entrez]
PHST- 2004/09/01 00:00 [pmc-release]
AID - 10.1136/heart.86.3.330 [doi]
PST - ppublish
SO  - Heart. 2001 Sep;86(3):330-5. doi: 10.1136/heart.86.3.330.