title: Is morbidity influenced by staging in the fontan palliation? A single center review.
abstract: In a retrospective study of 32 consecutive patients undergoing a total cavopulmonary connection (TCPC), we tried to determine if the trend for decreasing age at Fontan completion and reducing the intervals between the staged procedures during the past decade was associated with a change in morbidity and outcome. In 8 patients the Fontan circulation was completed in one stage and in 24 patients an intermediate step by hemi-Fontan or bidirectional cavopulmonary anastomosis was performed before Fontan completion. Mean age at TCPC and mean interval since the previous palliation have decreased significantly during the past decade. Although major complications were significantly reduced over time the occurrence and duration of postoperative pleural effusions were not. Decreasing age as well as intervals in staged Fontan palliation have beneficial influence on major complications and outcome, without significantly affecting the duration of pleural effusions at Fontan completion.
authors.affiliation: Department of Congenital Cardiac Surgery, University Hospital Gent, Belgium. Katrien.Francois@UGent.be
authors.forename: K
authors.initials: K
authors.lastname: Francois
authors.forename: M
authors.initials: M
authors.lastname: Tamim
authors.forename: T
authors.initials: T
authors.lastname: Bove
authors.forename: K
authors.initials: K
authors.lastname: De Groote
authors.forename: D
authors.initials: D
authors.lastname: De Wolf
authors.forename: D
authors.initials: D
authors.lastname: Matthys
authors.forename: B
authors.initials: B
authors.lastname: Suys
authors.forename: H
authors.initials: H
authors.lastname: Verhaaren
authors.forename: G
authors.initials: G
authors.lastname: Van Nooten
mesh_terms: D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure / Q000401:mortality*; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D009017:Morbidity / Q000639:trends; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome