title: Fontan operation and the cavopulmonary technique: immediate and late results according to the presence of atrial fenestration.
abstract: OBJECTIVE
  To compare immediate and late results in patients with or without fenestration who underwent cavopulmonary anastomosis so that we could assess the efficiency of the technique.
  
  
  METHODS
  Sixty-two patients underwent surgery between 1988 and 1999, 41 with fenestration (group I -G I) and 21 without fenestration (group II -G II). Tricuspid atresia was prevalent in group I (23-56%) and single ventricle was prevalent in group II (14-66%). Mean ages at the time of operation were 7.3 years in group I and 7.6 in group II. At late follow-up, mean ages were 10.6 years in group I and 12.8 years in group II.
  
  
  RESULTS
  Immediate and late mortality were 7.3% in G-I and 4.7% in G-II. Significant pleural effusion occurred in 41.4% of G-I patients and in 23.8% of G-II patients. Significant pericardial effusion occurred in 29.2% and 14.2%, respectively, in groups I and II. Central venous pressure was greater in G-II, 17.7 cm in H2O, as opposed to 15 cm in G-I. Hospital stay was similar between the groups, 26.3 and 21.8 days, respectively. Cyanosis and arterial insaturation occurred in 5 patients, and 4 patients were in functional class II, all from G-I. At late follow-up, 58 (93.5%) were in functional class I. Sinus rhythm was present in 94%, and pulmonary perfusion was similar in both groups. Eleven patients who underwent spirometry had good tolerance to physical effort.
  
  
  CONCLUSIONS
  Atrial fenestration did not improve the immediate or late follow-up of patients who underwent cavopulmonary anastomosis, and is, therefore, dispensable.
authors.affiliation: Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Edmar
authors.initials: E
authors.lastname: Atik
authors.forename: Nana Miura
authors.initials: NM
authors.lastname: Ikari
authors.forename: Tamara Cortez
authors.initials: TC
authors.lastname: Martins
authors.forename: Miguel
authors.initials: M
authors.lastname: Barbero-Marcial
mesh_terms: D002648:Child; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure / Q000379:methods / Q000401:mortality; D006325:Heart Atria / Q000002:abnormalities* / Q000601:surgery; D018610:Heart Bypass, Right / Q000379:methods* / Q000401:mortality; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D010490:Pericardial Effusion / Q000209:etiology; D010996:Pleural Effusion / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D016896:Treatment Outcome