Systolic and diastolic performance late after the Fontan procedure for a single ventricle and comparison of those undergoing operation at <12 months of age and at >12 months of age.
To evaluate whether surgical history can influence systolic and diastolic properties of a functional single left ventricle after Fontan operation, we echocardiographically investigated 31 patients (mean age 93.7 months; range 21 to 276); 21 patients were >12 months of age (group A) and 10 were <12 months of age (group B) at the time of the Fontan and/or cavopulmonary procedure. In group A we found persistent abnormalities of left ventricular mass index (95.9 vs 64.1 g/m(2), p <0.05) at long-term follow-up, whereas group B had normal left ventricular mass (61.9 vs 64.1 g/m2, p = NS). In contrast, a diastolic pattern characterized by augmented late diastolic filling was present in both patient groups regardless of age at operation and length of follow-up (E/A in group A 1.3 +/- 0.4, E/A in group B 1.6 +/- 1.5, E/A in controls 1.7 +/- 0.6; A vs B, p = NS; A vs controls, p <0.05). We concluded that patients with a single left ventricle who undergo an unloading procedure performed within the first year of life have complete normalization of left ventricular mass, although a diastolic filling pattern suggestive of augmented compliance persists, regardless of the age at operation.
Milanesi
Ornella
O
Department of Pediatrics, University of Padova, Medical School, Padova, Italy. ornella.milanesi@unipd.it
Stellin
Giovanni
G
Colan
Steven D
SD
Facchin
Paola
P
Crepaz
Roberto
R
Biffanti
Roberta
R
Zacchello
Franco
F
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D003971:Diastole; D004452:Echocardiography; D005260:Female; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000503:physiopathology* / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008499:Medical Records; D011184:Postoperative Period; D012189:Retrospective Studies; D013599:Systole; D013997:Time Factors; D016277:Ventricular Function, Left