PMID- 25803119
OWN - NLM
STAT- MEDLINE
DCOM- 20160513
LR  - 20150813
IS  - 1439-1902 (Electronic)
IS  - 0171-6425 (Linking)
VI  - 63
IP  - 5
DP  - 2015 Aug
TI  - Conversion to Total Cavopulmonary Connection Improves Functional Status Even in 
      Older Patients with Failing Fontan Circulation.
PG  - 380-7
LID - 10.1055/s-0035-1548735 [doi]
AB  - BACKGROUND: Facing longer follow-up of patients after Fontan operation, Fontan 
      conversion was proposed to treat failing Fontan circulation. We reviewed our 
      patients who reached up to 42 years of age. METHODS: Fifteen consecutive patients 
      underwent Fontan conversion to extracardiac conduit combined with biatrial maze 
      procedure between October 2006 and January 2014. Mean age at conversion was 
      30.9 +/- 5.6 years and mean interval from primary Fontan palliation to conversion 
      was 23.2 +/- 3.3 years. RESULTS: There was one early death. Ten of 14 survivors 
      were extubated within 24 hours, and 11 were discharged from intensive care unit 
      (ICU) within 7 days. The impaired left ventricular function, presented in four 
      patients prior to surgery, improved from EF 43.8 to 54.8% (p = 0.02). During 
      follow-up time of 3.6 +/- 2.3 years after conversion, there was no late death and 
      no reoperation. Two patients developed recurrent atrial arrhythmia. Older age at 
      Fontan procedure, lower left ventricular function, higher New York Heart 
      Association (NYHA) class, and anatomy other than tricuspid atresia emerged as 
      risk factors for longer ICU stay. CONCLUSION: Fontan conversion improved the 
      functional status in almost all patients. A concomitant maze procedure 
      effectively eliminated atrial arrhythmia. This procedure provides a benefit even 
      for older patients if all additional cardiac pathologies are addressed.
CI  - Georg Thieme Verlag KG Stuttgart . New York.
FAU - Ono, Masamichi
AU  - Ono M
AD  - Department of Cardiovascular Surgery, German Heart Center Munich, Technical 
      University, Munich, Germany.
FAU - Cleuziou, Julie
AU  - Cleuziou J
AD  - Department of Cardiovascular Surgery, German Heart Center Munich, Technical 
      University, Munich, Germany.
FAU - Kasnar-Samprec, Jelena
AU  - Kasnar-Samprec J
AD  - Department of Cardiovascular Surgery, German Heart Center Munich, Technical 
      University, Munich, Germany.
FAU - Burri, Melchior
AU  - Burri M
AD  - Department of Cardiovascular Surgery, German Heart Center Munich, Technical 
      University, Munich, Germany.
FAU - Hepp, Vanessa
AU  - Hepp V
AD  - Department of Cardiovascular Surgery, German Heart Center Munich, Technical 
      University, Munich, Germany.
FAU - Vogt, Manfred
AU  - Vogt M
AD  - Department of Pediatric Cardiology and Congenital Heart Disease, German Heart 
      Center Munich, Technical University, Munich, Germany.
FAU - Lange, Rudiger
AU  - Lange R
AD  - Department of Cardiovascular Surgery, German Heart Center Munich, Technical 
      University, Munich, Germany.
FAU - Schreiber, Christian
AU  - Schreiber C
AD  - Department of Cardiovascular Surgery, German Heart Center Munich, Technical 
      University, Munich, Germany.
FAU - Horer, Jurgen
AU  - Horer J
AD  - Department of Cardiovascular Surgery, German Heart Center Munich, Technical 
      University, Munich, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150324
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Analysis of Variance
MH  - Arrhythmias, Cardiac/etiology/physiopathology/*surgery
MH  - Cardiac Catheterization/methods
MH  - Cardiac Pacing, Artificial/*methods
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Fontan Procedure/*adverse effects/methods
MH  - Germany
MH  - Heart Defects, Congenital/diagnosis/surgery
MH  - Humans
MH  - Male
MH  - Pulmonary Artery/abnormalities/surgery
MH  - Reoperation/methods
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Statistics, Nonparametric
MH  - Survival Rate
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/etiology/*surgery
MH  - Young Adult
EDAT- 2015/03/25 06:00
MHDA- 2016/05/14 06:00
CRDT- 2015/03/25 06:00
PHST- 2015/03/25 06:00 [entrez]
PHST- 2015/03/25 06:00 [pubmed]
PHST- 2016/05/14 06:00 [medline]
AID - 10.1055/s-0035-1548735 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 2015 Aug;63(5):380-7. doi: 10.1055/s-0035-1548735. Epub 
      2015 Mar 24.