Early and late results of the modified Fontan procedure for double-inlet left ventricle: the Mayo Clinic experience.
Between May 1974 and March 1989, 155 patients with double-inlet left ventricle had the Fontan procedure performed at the Mayo Clinic. Age at operation ranged from nearly 2 to 41 years (median 10). The operative mortality rate from 1974 through 1980 (39 patients) was 21%, but from 1981 through 1989 (116 patients) it was reduced to 9%. The 17 late deaths were secondary to reoperation (n = 8), progressive myocardial failure (n = 5), sudden arrhythmia (n = 3) and bleeding varices (n = 1). Neither operative nor late mortality rate was significantly related to age at operation. At follow-up of 6 months to 11 years (mean 4.9 years) in 111 patients, 88% were in good or excellent condition and 12% were in fair or poor condition. The Fontan operation can be performed with a mortality risk of less than 10% in properly selected patients with double-inlet left ventricle. Late results are encouraging when contrasted with the clinical course of patients before this operative approach was utilized.
Mair
D D
DD
Department of Diagnostic Radiology, Mayo Clinic, Rochester, Minnesota 55905.
Hagler
D J
DJ
Julsrud
P R
PR
Puga
F J
FJ
Schaff
H V
HV
Danielson
G K
GK
D000046:Academic Medical Centers; D000293:Adolescent; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D006328:Cardiac Catheterization; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D006352:Heart Ventricles / Q000002:abnormalities*; D006439:Hemodynamics; D006801:Humans; D008910:Minnesota / Q000453:epidemiology; D010166:Palliative Care / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000592:standards; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D011237:Predictive Value of Tests; D011859:Radiography; D012086:Reoperation / Q000401:mortality / Q000706:statistics & numerical data; D013997:Time Factors