Fontan Operation. Hemodynamic Factors Associated With Postoperative Outcomes
| Autor: | Miguel A. Granados, Dolores Herrera, Jose M. Velasco, Alberto Mendoza, Victoria Ramos, Enrique Ruiz, Juan V. Comas, Ana Belén Fernández Pérez, Lorenzo Boni, Leticia Albert |
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| Rok vydání: | 2012 |
| Předmět: |
Heart Defects
Congenital Male Cardiac Catheterization medicine.medical_specialty medicine.medical_treatment Hemodynamics Fontan Procedure law.invention Bidirectional Glenn procedure Fontan procedure Risk Factors law Interquartile range medicine Cardiopulmonary bypass Humans Hospital Mortality Postoperative Period Child Retrospective Studies Cardiopulmonary Bypass business.industry Retrospective cohort study General Medicine Survival Analysis Univentricular heart Surgery Treatment Outcome Child Preschool Heart catheterization Female business Follow-Up Studies |
| Zdroj: | Revista Española de Cardiología (English Edition). 65:356-362 |
| ISSN: | 1885-5857 |
| DOI: | 10.1016/j.rec.2012.01.002 |
| Popis: | Introduction and objectives The Fontan operation is usually the final palliative procedure in patients with univentricular heart. The objectives of this study were, firstly, to describe the clinical and haemodynamic characteristics of a group of patients with univentricular physiology who had previously been palliated with a bidirectional Glenn procedure and, secondly, to identify risk factors that can influence postoperative outcomes after the Fontan operation. Methods Retrospective study with 32 patients who underwent a Fontan operation between March 2000 and December 2009. Clinical characteristics, catheterization data, type and duration of surgery were revised and analyzed as predictors of postoperative outcome. Results Hospital mortality was 3%. After a median follow-up of 44 months (interquartile range, 32-79), survival was 90%. Preoperative mean pulmonary arterial pressure (measured during catheterization) was correlated with late mortality. Of the remaining variables analyzed, the Nakata and McGoon indices, and duration of cardiopulmonary bypass showed the highest correlations with postoperative outcomes. Interventional catheterization before the Fontan operation was performed in 42% of patients. Conclusions Hospital mortality after the Fontan operation was very low. The performance of a haemodynamic study before the Fontan operation made it possible to select high-risk patients for surgery as well as permitting the performance of interventional procedures that could improve postoperative outcome in these patients. |
| Databáze: | OpenAIRE |
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