[Fontan procedure: early and mid-term results with total cavopulmonary anastomosis].
BACKGROUND
During the last five years, 65 patients with univentricular heart have been treated surgically in our institution, according to a protocol of staged operations that have been previously reported.


OBJECTIVE
To evaluate the early and mid-term outcome of those patients that have completed their staging protocol by means of a Fontan procedure.


METHODS
Between April 1996 and June 2001, 23 patients (age 16 to 223 months) underwent a Fontan procedure, 15 with an intracardiac lateral tunnel technique and 8 with an extracardiac conduit. A retrospective review of their clinical, surgical, echocardiographic, angiographic and hemodynamic data was performed, trying to identify risk factors for both mortality and functional capacity (FC). Follow up was complete in all survivors.


RESULTS
Three patients died early after surgery (13.04%). Excessive pulmonary blood flow was a risk factor for early death (p = 0.03). One patient died at 14 months. Follow up was 29.9 months (1-63). For those who survived the operation, five years survival was 93.3%. The majority of patients are in FC I or II, with no related risk factors.


CONCLUSIONS
Our current results are comparable with those of larger series. Patients reach good FC and mid-term survival, irrespective of type of single ventricle or the surgical strategy.
Becker
Pedro
P
Departamento de Enfermedades Cardiovasculares, Departamento de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Hospital Dr. Sótero del Río. pbecker@med.puc.cl
Frangini
Patricia
P
Urcelay
Gonzalo
G
Castillo
M Elisa
ME
Heusser
Felipe
F
Arnaiz
Pilar
P
Irarrázaval
Manuel J
MJ
Morán
Sergio
S
Zalaquett
Ricardo
R
Maturana
Gustavo
G
Arretz
Claudio
C
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure / Q000379:methods* / Q000401:mortality; D018610:Heart Bypass, Right / Q000379:methods / Q000401:mortality; D006330:Heart Defects, Congenital / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities*; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D014684:Venae Cavae / Q000601:surgery; D018754:Ventricular Dysfunction / Q000601:surgery*