11 Years of the Fontan operation at a single institution: Results from 87 consecutive patients.

Autor: Al Absi HS; Department of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates., Kiraly L; Division of Pediatric Cardiac Surgery, Department of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates., Mora B; Division of Pediatric Cardiac Surgery, Department of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates., Al Zoebie L; Department of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates., Al Shehhi S; Department of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates., Talo H; Division of Cardiology, Department of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
Jazyk: angličtina
Zdroj: Journal of cardiac surgery [J Card Surg] 2020 Mar; Vol. 35 (3), pp. 557-563. Date of Electronic Publication: 2020 Jan 16.
DOI: 10.1111/jocs.14425
Abstrakt: Fontan procedure is the preferred palliation for patients with single ventricles.
Objectives: To evaluate early morbidity and mortality after Fontan operation in 87 consecutive patients, between 2007 and 2017.
Methods: Early survival, duration of intensive care unit (ICU), and hospital stays were the main outcomes evaluated. Potential influencing factors evaluated included preoperative and intraoperative variables.
Results: Fontan procedure was performed at a median age of 4.2 years (range, 17 months-26 years), and a median weight of 15.5 kg (range, 8-72 kg). Extracardiac Fontan was the procedure of choice. The median cardiopulmonary bypass time was 122  minutes (range, 58-550 minutes). The majority had a fenestration (75 out of 87). Postoperatively, the median duration of ICU stay and total hospital stay were (4, 1-76 days) and (16, 1-85 days), respectively. Fontan failure occurred in one patient (1%). Overall early survival was 94%, resulting in a mortality rate of 6%. Univariate analysis showed that heterotaxy (odds ratio [OR], 2.222; confidence interval [CI], 1.345-6.250; P = .003) and decreased ventricular function (OR, 2.207; CI, 1.348-6.061; P = .002) significantly decreased survival. The same analysis failed to identify any statistically significant risk factors for prolonged hospital and ICU stays.
Conclusion: Our reported mortality and morbidity rates compared favorably with the reported rates. Therefore, Fontan operation can be performed in a tertiary care center in the United Arab Emirates with favorable early postoperative outcomes.
(© 2020 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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