Pulmonary artery growth fails to match the increase in body surface area after the Fontan operation.
OBJECTIVE
To evaluate the growth of the pulmonary arteries after a Fontan procedure.


METHODS
Retrospective review.


METHODS
Two paediatric cardiology tertiary care centres.


METHODS
61 children who underwent a modified Fontan operation and had angiography suitable for assessment of pulmonary artery size before the Fontan procedure and during long term follow up. An atriopulmonary connection (APC) was present in 23 patients (37.7%) and a total cavopulmonary connection (TCPC) was present in 38 (62.3%). Postoperative angiograms were performed 0.5-121 months (median 19 months) after the Fontan operation.


METHODS
Growth of each pulmonary artery measured just before the first branching point. The diameter was expressed as a z score with established nomograms used to standardise for body surface area.


RESULTS
The mean change in the preoperative to postoperative z scores of the right pulmonary artery was -1.06 (p = 0.004). The mean change in the preoperative to postoperative z scores of the left pulmonary artery was -0.88 (p = 0.003). Changes in the preoperative to postoperative z scores were more pronounced in the patients undergoing APC than TCPC, especially for the right pulmonary artery.


CONCLUSIONS
After the Fontan operation, growth of the pulmonary arteries often fails to match the increase in body surface area.
Tatum
G H
GH
Division of Cardiology, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213-2583, USA.
Sigfússon
G
G
Ettedgui
J A
JA
Myers
J L
JL
Cyran
S E
SE
Weber
H S
HS
Webber
S A
SA
D000293:Adolescent; D000328:Adult; D001830:Body Surface Area; D002648:Child; D002675:Child, Preschool; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery / Q000254:growth & development* / Q000601:surgery; D012189:Retrospective Studies