PMID- 15561013
OWN - NLM
STAT- MEDLINE
DCOM- 20050705
LR  - 20071115
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 78
IP  - 6
DP  - 2004 Dec
TI  - New onset arrhythmias after the extracardiac conduit Fontan operation compared 
      with the intraatrial lateral tunnel procedure: early and midterm results.
PG  - 1979-88; discussion 1988
AB  - BACKGROUND: Arrhythmias are one of the main causes of postoperative morbidity 
      superseding Fontan operations. Comparative data on the incidence of sinus node 
      dysfunction after the extracardiac Fontan operation (ECFO) and the intraatrial 
      lateral tunnel Fontan operation (LTFO) are very limited and controversial. The 
      aim of this study was to evaluate whether ECFO decreases the risk of 
      postoperative arrhythmias compared with LTFO. METHODS: Seventy-four consecutive 
      patients received either an LTFO (n = 29, 5 recordings in 1992 to 9 recordings in 
      1997) or an ECFO (n = 45, 11 recordings in 1995 to 5 recordings in 2001). The 
      rhythm was documented preoperatively and postoperatively with standard 
      electrocardiogram (ECG) recording and ECG monitoring. During follow-up all 
      patients had 2-8 (median 3) standard ECG recordings per year. Additionally 45 
      patients (65%) had a Holter ECG at least once a year. RESULTS: Median follow-up 
      post-ECFO was 4.4 years (1.6-7.2) and post-LTFO it was 7.9 years (5.4-11.1). 
      There were 5 early deaths (3 LTFO, 2 ECFO) and 1 late death (LTFO) (total 
      mortality 8%). Sinus rhythm persisted in 37 ECFO patients (86%) as compared with 
      13 LTFO patients (50%) (p < 0.001). The incidence of new onset supraventricular 
      tachyarrhythmias (SVTs) post-ECFO compared with LTFO was lower: 5 patients (11%) 
      versus 11 patients (38%) early postoperatively (p < 0.001) and none versus 7 
      patients (27%) during follow-up (p < 0.001), respectively. Early postoperatively 
      10 LTFO patients (34%) and another 3 patients during follow-up required permanent 
      pacemaker implantation due to bradyarrhythmias, but none of the ECFO patients 
      required this. CONCLUSIONS: Our data suggest that ECFO decreases the incidence of 
      postoperative new onset arrhythmias during early and midterm follow-up compared 
      with LTFO.
FAU - Nurnberg, Jan Hendrik
AU  - Nurnberg JH
AD  - Department of Congenital Heart Disease/Pediatric Cardiology, German Heart 
      Institute Berlin, Berlin, Germany. jan-hendrik.nuernberg@klinikum-bremen-ldw.de
FAU - Ovroutski, Stanislav
AU  - Ovroutski S
FAU - Alexi-Meskishvili, Vladimir
AU  - Alexi-Meskishvili V
FAU - Ewert, Peter
AU  - Ewert P
FAU - Hetzer, Roland
AU  - Hetzer R
FAU - Lange, Peter E
AU  - Lange PE
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Arrhythmias, Cardiac/diagnosis/*etiology
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Follow-Up Studies
MH  - Fontan Procedure/*methods
MH  - Humans
MH  - Infant
MH  - Logistic Models
MH  - Male
MH  - *Postoperative Complications/diagnosis
MH  - Proportional Hazards Models
MH  - Sinoatrial Node/physiopathology
EDAT- 2004/11/25 09:00
MHDA- 2005/07/06 09:00
CRDT- 2004/11/25 09:00
PHST- 2004/02/06 00:00 [accepted]
PHST- 2004/11/25 09:00 [pubmed]
PHST- 2005/07/06 09:00 [medline]
PHST- 2004/11/25 09:00 [entrez]
AID - S0003497504005144 [pii]
AID - 10.1016/j.athoracsur.2004.02.107 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2004 Dec;78(6):1979-88; discussion 1988. doi: 
      10.1016/j.athoracsur.2004.02.107.