Outcome and assessment after the modified fontan procedure for hypoplastic left heart syndrome

Paul E. Farrell, Anthony C. Chang, Kenneth A Murdison, Jeanne M. Baffa, William I. Norwood, John D. Murphy

Research output: Contribution to journalArticle

49 Scopus citations

Abstract

Background. We reviewed the outcome of 76 consecutive patients (age range, 5 months to 6 years; median age, 19 months) who underwent a modified Fontan procedure after initial palliative surgery for hypoplastic left heart syndrome (HLHS) between January 1984 and December 1989. Methods and Results. Modifications of the Fontan procedure included transatrial baffle of pulmonary venous return to the tricuspid valve (n=10) or inferior vena cava baffle within the right atrium to the superior vena caval-pulmonary artery anastomosis, with pulmonary artery augmentation (n=66). Actuarial survival rates were 74% (1 month), 58% (12 months), 56% (2 years), and 52% (4 years). Of the 43 survivors, 25 patients have returned for postoperative cardiac catheterization at a median of 13 months after the Fontan procedure. Mean±SD hemodynamic values were cardiac index, 2.8±0.61/min/m 2 ; right atrial pressure, 11±2 mm Hg; pulmonary artery wedge pressure, 6±3 mm Hg; and arterial oxygen saturation, 94±3%. No patient had significant tricuspid or native pulmonary valve insufficiency. Conclusions. Survival after the Fontan procedure in patients with HLHS is comparable to survival after a Fontan procedure in patients with other complex congenital heart lesions. In the subgroup of patients with HLHS who survived both reconstructive surgery and a Fontan procedure and have been evaluated by cardiac catheterization after a Fontan procedure, the use of the right ventricle as the systemic ventricle yielded excellent intermediate results for Fontan physiology.

Original languageEnglish (US)
Pages (from-to)116-122
Number of pages7
JournalCirculation
Volume85
Issue number1
DOIs
StatePublished - Jan 1 1992
Externally publishedYes

Keywords

  • Fontan procedure
  • Hemodynamics
  • Norwood procedure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'Outcome and assessment after the modified fontan procedure for hypoplastic left heart syndrome'. Together they form a unique fingerprint.

  • Cite this