title: Early and intermediate-term results of the extracardiac conduit total cavopulmonary connection for functional single-ventricle hearts.
abstract: OBJECTIVE
  Fontan operation has evolved from atriopulmonary connection to total cavopulmonary connection (TCPC) due to its advantages in terms of hemodynamics and reduction of atrium-related complications. We analyzed the early and intermediate-term results of extracardiac conduit TCPC (EC-TCPC) procedure in patients with functional single ventricle to investigate the risk factors of surgical mortality and intermediate failure.
  
  
  METHODS
  Retrospective review of the medical records of 88 consecutive patients with functional single ventricle who underwent EC-TCPC from 2000 to 2013 was conducted.
  
  
  RESULTS
  The follow-up was 100% complete, ranging from 3 months to 13 years (mean 7.0 ± 3.8 years). There were two (2.3%) hospital and 18 (20.4%) late deaths. The estimated event-free survival rates at 1 year, 5 years, and 10 years were 90.6%, 89.3%, and 77.2%, respectively. On univariate analysis, fenestration was the only risk factor for surgical mortality (p = 0.027). On multivariate analysis, the significant atrioventricular valve regurgitation was the only risk factor for intermediate failure (p = 0.017).
  
  
  CONCLUSIONS
  The clinical results of EC-TCPC in patients with functional single ventricle were satisfactory. The patients who needed fenestration during operation had higher risk of surgical mortality. Significant atrioventricular valve regurgitation had negative impact on intermediate survival.
authors: Department of Cardiovascular Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
authors: Jun-Yen
authors: JY
authors: Pan
authors: Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
authors: Chu-Chuan
authors: CC
authors: Lin
authors: Department of Cardiovascular Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
authors: Chieh-Jen
authors: CJ
authors: Wu
authors: Division of Thoracic and Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taiwan, ROC. Electronic address: c9112772@adm.cgmh.org.tw.
authors: Jen-Ping
authors: JP
authors: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000401:mortality* / Q000601:surgery*; D006352:Heart Ventricles / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D011651:Pulmonary Artery / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D013624:Taiwan; D016896:Treatment Outcome; D055815:Young Adult
keywords: Fontan; single ventricle; total cavopulmonary connection