Epicardial Atrial Pacing After the Extracardiac Fontan Operation: Feasibility of an Entirely Transvenous Approach

2021 ◽  
Author(s):  
Walter J. Hoyt ◽  
Jeremy P. Moore ◽  
Kevin M. Shannon ◽  
Prince J. Kannankeril ◽  
Frank A. Fish
Keyword(s):  
Fontan Operation ◽  
Atrial Pacing ◽  
Transvenous Approach ◽  
Extracardiac Fontan

Outcomes of the Extracardiac Fontan Procedure Using Cardiopulmonary Bypass: Early Results

2014 ◽  
Vol 17 (3) ◽  
pp. 173 ◽  
Author(s):  
Murat Ugurlucan ◽  
Eylem Yayla Tuncer ◽  
Fusun Guzelmeric ◽  
Eylul Kafali ◽  
Omer Ali Sayin ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Fontan Procedure ◽  
Fontan Operation ◽  
Arterial Oxygen Saturation ◽  
Vena Cava ◽  
Arterial Oxygen ◽  
Shunt Operation ◽  
Early Results ◽  
The Mean ◽  
Extracardiac Fontan

<p><strong>Background</strong>: Although the avoidance of cardiopulmonary bypass during the Fontan procedure has potential advantages, using cardiopulmonary bypass during this procedure has no adverse effects in terms of morbidity and mortality rates. In this study, we assessed the postoperative outcomes of our first 9 patients who have undergone extracardiac Fontan operation by the same surgeon using cardiopulmonary bypass.</p><p><strong>Methods</strong>: Between September 2011 and April 2013,  9 consecutive patients (3 males and 6 females) underwent extra-cardiac Fontan operation. All operations were performed under cardiopulmonary bypass at normothermia by the same surgeon.  The age of patients ranged between 4 and 17 (9.8 ± 4.2) years. Previous operations performed on these patients were modified Blalock-Taussig shunt procedure in 2 patients, bidirectional cavopulmonary shunt operation in 6 patients, and pulmonary arterial banding in 1 patient. Except 2 patients who required intracardiac intervention, cross-clamping was not applied. In all patients, the extracardiac Fontan procedure was carried out by interposing an appropriately sized tube graft between the infe-rior vena cava and right pulmonary artery.</p><p><strong>Results</strong>: The mean intraoperative Fontan pressure and transpulmonary gradient were 12.3 ± 2.5 and 6.9 ± 2.2 mm Hg, respectively. Intraoperative fenestration was not required. There was no mortality and 7 patients were discharged with-out complications. Complications included persistent pleural effusion in 1 patient and a transient neurological event in 1 patient. All patients were weaned off mechanical ventila-tion within 24 hours. The mean arterial oxygen saturation increased from 76.1% ± 5.3% to 93.5% ± 2.2%. All patients were in sinus rhythm postoperatively. Five patients required blood and blood-product transfusions. The mean intensive care unit and hospital stay periods were 2.9 ± 1.7 and 8.2 ±  1.9 days, respectively.</p><p><strong>Conclusions</strong>: The extracardiac Fontan operation per-formed using cardiopulmonary bypass provides satisfactory results in short-term follow-up and is associated with favor-able postoperative hemodynamics and morbidity rates.</p>

scholarly journals Atrial pacing: An alternative treatment for protein-losing enteropathy after the Fontan operation

2001 ◽  
Vol 121 (3) ◽  
pp. 582-583 ◽  
Author(s):  
Mitchell I. Cohen ◽  
Larry A. Rhodes ◽  
Gil Wernovsky ◽  
J.William Gaynor ◽  
Thomas L. Spray ◽  
...  
Keyword(s):  
Alternative Treatment ◽  
Fontan Operation ◽  
Atrial Pacing ◽  
Protein Losing Enteropathy

Extracardiac Fontan Operation: How I Teach It

2020 ◽  
Vol 110 (4) ◽  
pp. 1119-1122
Author(s):  
Taufiek Konrad Rajab ◽  
James Jaggers
Keyword(s):  
Fontan Operation ◽  
Extracardiac Fontan

Extracardiac Fontan Operation

2005 ◽  
pp. 585-592
Author(s):  
Ed Petrossian ◽  
V. Mohan Reddy ◽  
Frank L. Hanley
Keyword(s):  
Fontan Operation ◽  
Extracardiac Fontan

scholarly journals Optimal conduit size for extracardiac Fontan operation✩

2000 ◽  
Vol 18 (6) ◽  
pp. 690-695 ◽  
Author(s):  
Vladimir Alexi-Meskishvili ◽  
Stanislav Ovroutski ◽  
Peter Ewert ◽  
Ingo Dähnert ◽  
Felix Berger ◽  
...  
Keyword(s):  
Fontan Operation ◽  
Extracardiac Fontan

Extracardiac Fontan Operation after Late Bidirectional Glenn Shunt

2010 ◽  
Vol 18 (3) ◽  
pp. 253-259 ◽  
Author(s):  
Madhusudan Ganigara ◽  
Atul Prabhu ◽  
Roy Varghese ◽  
Sreeja Pavithran ◽  
John Valliatu ◽  
...  
Keyword(s):  
Fontan Operation ◽  
Glenn Shunt ◽  
Bidirectional Glenn ◽  
Bidirectional Glenn Shunt ◽  
Extracardiac Fontan

scholarly journals Systemic right ventricular morphology in the early postoperative course after extracardiac Fontan operation: is there still a need for special care?

2016 ◽  
pp. ezw374
Author(s):  
Sarah Nordmeyer ◽  
Melanie Rohder ◽  
Johannes Nordmeyer ◽  
Oliver Miera ◽  
Björn Peters ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Fontan Operation ◽  
Special Care ◽  
Postoperative Course ◽  
Extracardiac Fontan

scholarly journals Mid-term outcome of extracardiac Fontan operation using Contegra conduit

2013 ◽  
Vol 25 (2) ◽  
pp. 125
Author(s):  
Deraz Al Sayed Salem ◽  
Arfi Muhammed Amin ◽  
Sharfi Hussain Masroor ◽  
Fouad Ismail Muhamed ◽  
Baslaim Ghassan ◽  
...  
Keyword(s):  
Fontan Operation ◽  
Term Outcome ◽  
Extracardiac Fontan

scholarly journals Intra- or extracardiac Fontan operation? A simple strategy when to do what

2014 ◽  
Vol 4 ◽  
pp. 706-710
Author(s):  
Wlodzimierz Kuroczynski ◽  
David Senft ◽  
Amelie Elsaesser ◽  
Christoph Kampmann
Keyword(s):  
Fontan Operation ◽  
Simple Strategy ◽  
Extracardiac Fontan

Outcomes of the Non-fenestrated Fontan Procedure at High Altitude

2019 ◽  
Vol 10 (5) ◽  
pp. 590-596 ◽  
Author(s):  
Alexis Palacios-Macedo ◽  
Héctor Díliz-Nava ◽  
Orlando Tamariz-Cruz ◽  
Luis García-Benítez ◽  
Fabiola Pérez-Juárez ◽  
...  
Keyword(s):  
Risk Factor ◽  
Oxygen Saturation ◽  
High Altitude ◽  
Fontan Procedure ◽  
Fontan Operation ◽  
Hospital Death ◽  
Medium Term ◽  
Drainage Time ◽  
Extracardiac Fontan

Background: Although high altitude has been considered a risk factor for the Fontan operation, and an indication for fenestration, there is a paucity of data to support its routine use. Fenestration, with its necessary right to left induced shunt, together with the lower partial pressure of oxygen found with progressive altitude, can significantly decrease hemoglobin oxygen saturation, and therefore, it would be desirable to avoid it. Objective: To analyze immediate and medium-term results of the non-fenestrated, extracardiac, Fontan procedure at high altitude. Methods: Retrospective analysis of data from consecutive patients who underwent non-fenestrated, extracardiac, Fontan procedure at two institutions located in Mexico City at 2,312 m (7,585 ft) and 2,691 m (8,828 ft) above sea level. High altitude was not considered a risk factor. Results: Thirty-nine patients were included, with a mean age of 6.7 years. Mean preoperative indexed pulmonary vascular resistance was 1.7 Wood units. Seventy-nine percent of the patients extubated in the operating room. There was one in-hospital death (2.56%) and one at follow-up. Median chest tube drainage time was 6.5 and 6 days for the right and left pleural spaces. Median oxygen saturation at discharge was 90%. At a median follow-up of six months, all survivors, except one, had good tolerance to daily life activities. Conclusions: The present study shows good short- and medium-term results for the non-fenestrated, extracardiac, Fontan operation at altitudes between 2,300 and 2,700 m and might favor this strategy over fenestration to improve postoperative oxygen saturation. Further studies to examine the long-term outcomes of this approach need to be considered.

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