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Outcome and assessment after the modified Fontan procedure for hypoplastic left heart syndrome

, : Outcome and assessment after the modified Fontan procedure for hypoplastic left heart syndrome. Circulation 85(1): 116-122

Background. We reviewed the outcome of 76 consecutive patients (age range, 5 months to 6 years; median age, 19 months) who underwent a modified Fontan procedure after initial palliative surgery for hypoplastic left heart syndrome (HLHS) between January 1984 and December 1989 methods and Results. Modifications of the Fontan procedure included transatrial baffle or pulmonary venous return to the tricuspid valve (n = 10) or inferior vena cava baffle within the right atrium to the superior vena caval-pulmonary artery anastomosis, with pulmonary artery augmentation (n = 66). Actuarial survival rates were 74% (1 month), 58% (12 months), 56% (2 years), and 52% (4 years). Of the 43 survivors, 25 patients have returned have returned for postoperative cardiac catheterization at a median of 13 months after the Fontan procedure. Mean .+-. SD hemodynamic values were cardiac index, 2.8 .+-. 0.6 lmin/m2; right atrial pressure, 11 .+-. 2 mm Hg; pulmonary artery wedge pressure, 6 .+-. 3 mm Hg; and arterial oxygen saturation, 94 .+-. 3%. No patient had significant tricuspid or native pulmonary valve insufficiency. Conclusions. Survival after the Fontan procedure in patients with HLHS is comparable to survival after a Fontan procedure in patients with HLHS is comparable to the subgroup of patients with HLHS who survived both reconstrictive surgery and a Fontan procedure and have been evaluated by cardiac catheterization after a Fontan procedure, the use of the right ventricular as the systemic ventricle yielded excellent intermediate results for Fontan physiology.


PMID: 1728440

DOI: 10.1161/01.CIR.85.1.116

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