The Fontan operation in infants less than 2 years of age.
Publication/Presentation Date
3-15-1992
Abstract
Young age remains a reported risk factor for a successful Fontan operation despite improved survival rates. Since March 1978, the Fontan operation has been performed in 47 patients. To avoid a primary or secondary palliative shunt, an early Fontan procedure (Group 1: mean age 1.5 +/- 0.5 years, range 0.6 to 2) has been performed in 17 children with the outcome similar to that of the remaining 30 older patients (Group 2: mean age 7.5 +/- 5 years, range 2.4 to 23 years). Preoperatively both groups had acceptable hemodynamic status for a successful Fontan result. Operative variables including cardiopulmonary bypass time, aortic cross-clamp time and core temperature were similar between groups and did not affect mortality. The postoperative mortality rate including early surgical (0% vs. 13%, respectively), late (18% vs. 12%) and total (18% vs. 23%) was similar between Groups 1 and 2 (p greater than 0.05). Immediate postoperative arrhythmias were more frequent in Group 1 (71% vs. 25%, p less than 0.01) with no related mortality, while late arrhythmias occurred with equal frequency (29% vs. 39%, p greater than 0.05). Group 1 infants required a longer hospital stay (22 +/- 9 vs. 14 +/- 5 days, p less than 0.01). Thus, young age is not a risk factor for successful outcome of the Fontan operation in patients with acceptable preoperative hemodynamic status. An early Fontan operation may also avoid prolonged palliative procedures and their potential deleterious effects.
Volume
19
Issue
4
First Page
828
Last Page
833
ISSN
0735-1097
Published In/Presented At
Weber, H. S., Gleason, M. M., Myers, J. L., Waldhausen, J. A., Cyran, S. E., & Baylen, B. G. (1992). The Fontan operation in infants less than 2 years of age. Journal of the American College of Cardiology, 19(4), 828–833. https://doi.org/10.1016/0735-1097(92)90526-s
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
1372014
Department(s)
Department of Pediatrics
Document Type
Article