[The limits for modified Fontan operations with AV valve regurgitation--the effect of AV valve regurgitation on the Fontan operation for single ventricle].
We performed a modified Fontan operation on 14 patients of single ventricle with AV valve regurgitation (single right ventricle: SRV 8, single left ventricle: SLV 6) until 1990. During the same period, 41 patients of single ventricle without AV valve regurgitation underwent the modified Fontan operation. To evaluate the effect of AV valve regurgitation on the Fontan operation, operative mortality, ventricular and pulmonary functions were compared between two groups. No significant differences were observed in operative mortality (7% vs 12%). There were also no significant differences of post-operative cardiac index (mean 2.6 L/min/m2 vs 2.6 L/min/m2), pulmonary vascular resistance (mean 2.3 U.m2 vs 2.2 U.m2) and preoperative ejection fraction (mean 54% vs 62%) between two groups. Therefore, the hemodynamic status of single ventricle following the Fontan operation remained almost unchanged irrespective of the presence of AV valve regurgitation. This suggested that AV valve regurgitation was not itself a contraindication of the Fontan operation, if the correct indices and time for operation were selected.
Department of Pediatric Cardiovascular Surgery, Tokyo Women's Medical College, Japan.
T
T
Hiramatsu
Y
Y
Imai
K
K
Sawatari
T
T
Takeuchi
M
M
Terada
M
M
Aoki
T
T
Isomatsu
I
I
Park
D006325:Heart Atria / Q000601:surgery; D006352:Heart Ventricles / Q000002:abnormalities* / Q000601:surgery*; D006801:Humans; D011651:Pulmonary Artery / Q000601:surgery; D014261:Tricuspid Valve / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000150:complications* / Q000601:surgery