title: Outcome of the Fontan procedure in patients with tricuspid atresia.
abstract: Between 1973 and 1983, 90 patients with tricuspid atresia underwent the Fontan operation at the Mayo Clinic. Operative mortality was 12% overall and decreased to 7% during the second 5 year period. At postoperative follow-up of 65 patients (1 to 10 years, mean 4), 50 (86%) of 58 present survivors were in excellent condition. There had been seven late deaths. Catheterization 0.5 to 8 years (mean 2.7) postoperatively in 25 patients disclosed a mean right atrial pressure of 14 mm Hg (range 6 to 21) and a mean cardiac index at rest of 3.0 (range 1.8 to 4.2). Mean left ventricular end-diastolic pressure was 8.5 mm Hg postoperatively compared with 16.5 mm Hg preoperatively; the decrease was secondary to a decreased ventricular volume load (mean volume load index 10.2 preoperatively, 3.0 postoperatively). We recommend that patients with tricuspid atresia have the Fontan operation by age 6 years to protect myocardial function.
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006325:Heart Atria / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000401:mortality; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011184:Postoperative Period; D011300:Preoperative Care; D011651:Pulmonary Artery / Q000601:surgery; D014261:Tricuspid Valve / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery