Long-term cardiopulmonary exercise capacity after modified Fontan operation.
OBJECTIVE
Early circuit separation enhances the long-term success of Fontan haemodynamics. To test this hypothesis, we analysed the postoperative cardiopulmonary capacity in children and adults.


METHODS
Spiroergometry was performed at least twice in 43 patients with a median age of 14 (range: 7-43) years, with a median time interval of 4.6 (1.1-10.4) years between early and late testing. Twenty-eight patients had been operated on in childhood and 15 as adults. The exercise capacity (W(max)) and oxygen consumption capacity (VO(2max)) were compared between children and adults.


RESULTS
The VO(2max) in children early postoperatively was better than in adults (median 27.9 vs 22.9, p=0.032). Both VO(2max) (median 30.1 ml min(-1) kg(-1) vs 16.9 ml min(-1)kg(-1), p<0.001), and W(max) (median 2.2 W kg(-1) vs 1.4 W kg(-1), p<0.001) were significantly better in children late after surgery. In the patient group as a whole, there was a significant decrease of VO(2max) between early and later testing (median 26.5 l min(-1) kg(-1) vs 20.7 l min(-1) kg(-1), p<0.001).


CONCLUSIONS
Fontan palliation in early childhood results in better cardiopulmonary capacity during long-term follow-up. Regular surveillance of the physical capacity by spiroergometry is indispensable for the supervision of patients with Fontan haemodynamics.
Ovroutski
Stanislav
S
Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany. ovroutski@dhzb.de
Ewert
Peter
P
Miera
Oliver
O
Alexi-Meskishvili
Vladimir
V
Peters
Bjorn
B
Hetzer
Roland
R
Berger
Felix
F
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D005080:Exercise Test / Q000379:methods; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D018729:Fontan Procedure / Q000379:methods*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D011184:Postoperative Period; D055815:Young Adult