Univentricular repair. Early and midterm results.
A total of 202 patients (62 with tricuspid atresia and 140 without tricuspid atresia) underwent univentricular repair at our unit from January 1990 to September 1994. Of these patients, 182 had nonfenestrated and 20 had fenestrated interatrial baffles. Early mortality was 15.9% (29/182) in the group with nonfenestrated baffles and 5% (1/20) in the group with fenestrated baffles. The follow-up period ranged from 2 to 58 months. Seven late deaths occurred, and five patients were lost to follow-up. Of 160 patients who have been evaluated in the outpatient department in the past 3 months, 142 (88.75%) required no cardiac medicines and were in functional class I. Risk factors analyzed for early mortality and significant effusion were age, preoperative diagnosis, type of Fontan modification, cardiopulmonary bypass time, aortic crossclamp time, pulmonary artery size, associated pulmonary arterioplasty, takedown of systemic-pulmonary artery shunt, and pulmonary artery debanding, along with the Fontan operation. Bypass time exceeding 120 minutes was associated with a higher early mortality (12/47 vs 18/155; p = 0.0187). Bypass time exceeding 120 minutes (p = 0.0456) and aortic crossclamp time exceeding 60 minutes (p = 0.0278) were associated with significant postoperative effusion. Other factors were not associated with any significantly increased risk for early mortality or postoperative effusions. Fenestration of the interatrial baffle appeared to decrease early mortality, although the numbers are too small to be statistically significant. The prevalence of effusions did not differ significantly between the group with fenestrated baffles and the group without fenestrated baffles.
Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.
R
R
Sharma
K S
KS
Iyer
B
B
Airan
K
K
Saha
B
B
Das
A
A
Bhan
I M
IM
Rao
P
P
Venugopal
D002315:Cardiopulmonary Bypass; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure / Q000379:methods* / Q000401:mortality*; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery; D006801:Humans; D008297:Male; D010996:Pleural Effusion / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome