title: Results of the Fontan operation with no early mortality in 248 consecutive patients.
abstract: BACKGROUND
  The Fontan operation has undergone several modifications and today is the primary way to treat a broad spectrum of congenital heart defects.
  
  
  OBJECTIVE
  The purpose of this study is to present the results of treatment of children with a single ventricle operated by the same surgical team and managed according to a uniform strategy.
  
  
  METHODS
  In the years 2007-2015, in 248 children aged 3.7 ± 2.6 years and weighing 14.6 ± 6.1 kg with a single ventricle, Fontan surgery was performed. In 56 (22.6%) children surgery was based on the creation of an intra-atrial lateral tunnel, and in 192 (77.4%) patients extracardiac modification was performed. In most patients, the operation was carried out with the normothermic cardiopulmonary bypass, on a "beating heart" without aortic cross-clamp. The average cardiopulmonary bypass time was 53.9 ± 23.9 min. The most common indication for surgery was hypoplastic left heart syndrome (53.6%). All patients with a single ventricle referred to our hospital for the Fontan procedure were enrolled into the surgery programme.
  
  
  RESULTS
  All patients survived the operation and were discharged home. Thirty-six (14.5%) patients were extubated in the operating room, in other patients the mean duration of the mechanical ventilation was 9.7 ± 16.1 h (median 7 h). The average time of hospitalisation in the whole study group was 17.5 ± 18.5 days (median 15 days). After surgery, in four children transient seizures occurred, and three patients had an ischaemic stroke.
  
  
  CONCLUSIONS
  Developing and obeying a fixed perioperative protocol is crucial for low mortality and small number of complications after Fontan operation.
authors.forename: Edward
authors.initials: E
authors.lastname: Malec
authors.forename: Christoph
authors.initials: C
authors.lastname: Schmidt
authors.forename: Anja
authors.initials: A
authors.lastname: Lehner
authors.affiliation: Department of Cardiothoracic Surgery, Division of Paediatric Cardiac Surgery, University Hospital Münster, Germany. Katarzyna.Januszewska@ukmuenster.de.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Januszewska
mesh_terms: D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D007223:Infant; D016896:Treatment Outcome
keywords: Fontan operation; single ventricle