title: A congenitally "poor" pulmonary artery is a major reason for exclusion from Fontan operation.
abstract: We reviewed the clinical records of 185 patients who were possible candidates for Fontan operation. We did this to clarify whether all patients with suitable anomalies ultimately underwent a Fontan operation. Of the 152 patients with decreased pulmonary blood flow, 38 (26%) did not fulfill the criteria for Fontan operation, and 17 of the 33 patients (52%) with increased pulmonary blood flow (P < 0.01) were excluded as candidates. Of 48 non-candidate survivors, 19 had high pulmonary artery (PA) pressure or resistance and small PA (which we term "poor PA"), 17 had pulmonary hypertension, 6 had a markedly distorted PA, and 6 had severe ventricular dysfunction. A significant proportion of possible candidates with a suitable anomaly ultimately did not undergo a Fontan operation, because of "poor PA", a congenital condition that precluded Fontan operation.
authors.affiliation: Department of Pediatric Cardiology, Heart Institute of Japan, Tokyo Women's Medical College, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nakazawa
authors.forename: I
authors.initials: I
authors.lastname: Park
authors.forename: M
authors.initials: M
authors.lastname: Yamada
authors.forename: T
authors.initials: T
authors.lastname: Nakanishi
authors.forename: K
authors.initials: K
authors.lastname: Momma
authors.forename: S
authors.initials: S
authors.lastname: Hoshino
authors.forename: Y
authors.initials: Y
authors.lastname: Takanashi
authors.forename: Y
authors.initials: Y
authors.lastname: Imai
mesh_terms: D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D006328:Cardiac Catheterization / Q000379:methods; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D018729:Fontan Procedure / Q000401:mortality; D006330:Heart Defects, Congenital / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000503:physiopathology; D007223:Infant; D010166:Palliative Care / Q000379:methods; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000503:physiopathology; D012189:Retrospective Studies; D015996:Survival Rate; D014655:Vascular Resistance