title: Feasibility of the extracardiac conduit Fontan procedure in patients weighing less than 10 kilograms.
abstract: OBJECTIVE
  The extracardiac conduit Fontan procedure has led to improved outcomes. We performed the procedure in patients weighing less than 10 kg and evaluated its feasibility.
  
  
  METHODS
  Since January 1999, 72 patients weighing less than 20 kg underwent extracardiac conduit Fontan procedure with polytetrafluoroethylene conduits. The patients were divided into 2 groups: 36 patients weighing less than 10 kg in group S and 36 weighing more than 10 kg in group L. Mean weight, median age, and median follow-up period in groups S and L were 8.5 +/- 1.1 and 14.0 +/- 3.0 kg, 18.9 and 42.0 months, and 29.2 (1.7-79.7) and 42.1 (2.8-94.2) months, respectively. Postoperatively, most patients received peritoneal drainage catheters. We reviewed data precatheterization and postcatheterization and postoperative course.
  
  
  RESULTS
  Conduit sizes in groups S and L were 17.0 +/- 1.3 and 17.9 +/- 1.9 mm, respectively (P = .03). Five patients required fenestrations. There were 2 hospital deaths, 1 in each group, and 2 late deaths in group S. The postoperative course was identical in both groups, except for median length of stay in the intensive care unit and peritoneal drainage volume. Group S versus L: ventilator support, 11 versus 7 hours; pleural drainage, 9 days each; pleural drainage greater than 14 days, 6 versus 5 cases; peritoneal drainage, 8 versus 7 days; intensive care unit stay, 7 versus 4 days (P = .01), peritoneal drainage volume, 26.1 versus 14.1 mL x kg x d(-1) (P = .0007).
  
  
  CONCLUSIONS
  The early outcome of the extracardiac conduit Fontan procedure was satisfactory in patients weighing less than 10 kg. However, the required size of the conduit remains debatable.
authors.affiliation: Department of Cardiovascular Surgery, Iwate Medical University Memorial Heart Center, Shizuoka, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Ikai
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Keiichi
authors.initials: K
authors.lastname: Hirose
authors.forename: Noritaka
authors.initials: N
authors.lastname: Ota
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tosaka
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakata
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Ide
authors.forename: Kisaburo
authors.initials: K
authors.lastname: Sakamoto
mesh_terms: D001835:Body Weight; D002675:Child, Preschool; D005240:Feasibility Studies; D018729:Fontan Procedure / Q000379:methods*; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D007223:Infant; D016896:Treatment Outcome