Non-fenestrated Extracardiac Fontan

CSurgeries ◽  
2021 ◽  
Author(s):  
Ethan Chernivec ◽  
Chris Eisenring ◽  
Lawrence Greiten ◽  
Brian Reemtsen
Keyword(s):  
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>

Severe conduit stenosis in a patient with Fontan circulation with a Y-shaped Dacron conduit

2021 ◽  
pp. 1-3
Author(s):  
Daiji Takajo ◽  
Preetha L. Balakrishnan ◽  
Sanjeev Aggarwal
Keyword(s):  
Energy Loss ◽  
Polyethylene Terephthalate ◽  
Rare Complication ◽  
Flow Distribution ◽  
Fontan Circulation ◽  
Distribution Data ◽  
Extracardiac Fontan ◽  
Fontan Palliation

Abstract Conduit stenosis is a major, albeit rare, complication following the Fontan palliation. A single-baffle conduit with polytetrafluoroethylene is widely used for an extracardiac type Fontan palliation. A polyethylene terephthalate conduit (Dacron) is sometimes used for the conduit when more flexibility is required. A Y-shaped conduit is rarely used, but it may reduce the energy loss and achieve better hepatic flow distribution. Data on the long-term patency and complications when using a Y-shaped Dacron conduit is lacking. We report a case of a severely stenotic Y-shaped Dacron conduit in a patient who underwent extracardiac Fontan palliation.

Compression of an Extracardiac Fontan Following Classic Fontan Revision

2004 ◽  
Vol 19 (3) ◽  
pp. 254-257 ◽  
Author(s):  
Jefferson M. Lyons ◽  
Jodie Y. Duffy ◽  
Peter B. Manning ◽  
Jeffrey M. Pearl
Keyword(s):  
Extracardiac Fontan

Lumped parameter models for two-ventricle and healthy and failing extracardiac Fontan circulations

2021 ◽  
Author(s):  
Matthew G Doyle ◽  
Marina Chugunova ◽  
S Lucy Roche ◽  
James P Keener
Keyword(s):  
Single Ventricle ◽  
Left Ventricular ◽  
Sensitivity Analyses ◽  
Surgical Strategies ◽  
Lumped Parameter ◽  
Lumped Parameter Models ◽  
Fontan Failure ◽  
Existence Of Periodic Solutions ◽  
Mathematical Definitions ◽  
Extracardiac Fontan

Abstract Fontan circulations are surgical strategies to treat infants born with single ventricle physiology. Clinical and mathematical definitions of Fontan failure are lacking, and understanding is needed of parameters indicative of declining physiologies. Our objective is to develop lumped parameter models of two-ventricle and single-ventricle circulations. These models, their mathematical formulations and a proof of existence of periodic solutions are presented. Sensitivity analyses are performed to identify key parameters. Systemic venous and systolic left ventricular compliances and systemic capillary and pulmonary venous resistances are identified as key parameters. Our models serve as a framework to study the differences between two-ventricle and single-ventricle physiologies and healthy and failing Fontan circulations.

Magnetic Resonance Flow Analysis of Classic and Extracardiac Fontan Procedures: The Seesaw Sign

2004 ◽  
Vol 20 (5) ◽  
pp. 397-405 ◽  
Author(s):  
S. Bruce Greenberg ◽  
W. Robert Morrow ◽  
Michiaki Imamura ◽  
Jonathan Drummond-Webb
Keyword(s):  
Magnetic Resonance ◽  
Flow Analysis ◽  
Resonance Flow ◽  
Extracardiac Fontan

scholarly journals Intra-Extracardiac Versus Extracardiac Fontan Modifications: Comparison of Early Outcomes

2019 ◽  
Vol 107 (2) ◽  
pp. 560-566 ◽  
Author(s):  
Lok Sinha ◽  
Mahmut Ozturk ◽  
David Zurakowski ◽  
Can Yerebakan ◽  
Karthik Ramakrishnan ◽  
...  
Keyword(s):  
Extracardiac Fontan

Outcomes among adult survivors of total cavopulmonary Fontan palliation for single ventricle

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319760
Author(s):  
Christopher Anigwe ◽  
Vidhushei Yogeswaran ◽  
Anita Moon-Grady ◽  
Sophie McAllister ◽  
Anika Aggarwal ◽  
...  
Keyword(s):  
Single Ventricle ◽  
Adverse Outcome ◽  
Survival Rates ◽  
Adult Survivors ◽  
Adverse Outcomes ◽  
Protein Losing Enteropathy ◽  
Tertiary Centre ◽  
Lateral Tunnel ◽  
Extracardiac Fontan ◽  
Fontan Palliation

ObjectiveThis tertiary centre study aims to identify factors associated with adverse outcomes in adult survivors with total cavopulmonary connection (TCPC) Fontan palliation for single ventricle.MethodsThis retrospective review of medical records identified adult (≥18 years) survivors of TCPC Fontan palliation who were followed at a single tertiary centre between 1 January 2000 and 1 July 2019. Adverse outcomes were defined as arrhythmia, pacemaker/implantable cardioverter defibrillator placement, liver cirrhosis, protein losing enteropathy, hospitalisation for heart failure, thromboembolic complication and/or death.Results160 adult TCPC patients met the inclusion criteria: 117 (73.1%) extracardiac and 43 (26.9%) lateral tunnel. The median (IQR) duration of follow-up since TCPC palliation was 17.5 (11.8–21.3) years. An adverse outcome occurred in 87 (54.4%) patients. Adverse outcome-free survival rates at 10, 20 and 25 years post TCPC were 89% (95% CI 82% to 93%), 60% (95% CI 50% to 69%) and 24% (95% CI 15% to 35%), respectively. On multivariate analysis, extracardiac Fontan (HR 2.21, 95% CI 1.20 to 4.08, p=0.011) was observed to be an independent risk factor for adverse outcomes after adjusting for age, race, morphology of the systemic ventricle and history of fenestration.ConclusionsIn this single-centre retrospective study of adult survivors of TCPC palliation, extracardiac Fontan was associated with an increased hazard for adverse outcomes. This finding could guide clinicians in developing risk modification strategies and management decisions to improve long-term outcomes in these patients.

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