Surgical outcome of Fontan conversion and arrhythmia surgery: Need a pacemaker?
| Autor: | Hajime Sakurai, Takahisa Sakurai, Takafumi Terada, Toshimichi Nonaka, Junya Sugiura, Tetsuyoshi Taneichi, Ryohei Ohtsuka |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Reoperation Pulmonary and Respiratory Medicine Tachycardia Pacemaker Artificial medicine.medical_specialty Poor prognosis Time Factors Adolescent medicine.medical_treatment Catheter ablation Fontan Procedure Cryosurgery Fontan procedure Young Adult Recurrence Risk Factors Internal medicine Atrial Fibrillation Tachycardia Supraventricular Humans Medicine cardiovascular diseases Arrhythmia surgery Child business.industry Cardiac Pacing Artificial Atrial fibrillation General Medicine medicine.disease Surgery Treatment Outcome Late period Catheter Ablation cardiovascular system Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Asian Cardiovascular and Thoracic Annals. 22:682-686 |
| ISSN: | 1816-5370 0218-4923 |
| Popis: | Background Atrial tachyarrhythmias are frequent complications in the late period after the Fontan procedure, and important risk factors for a poor prognosis. The impact of Fontan conversion and arrhythmia surgery in failed Fontan patients has been described in many reports. Objective We evaluated our experience with Fontan conversion procedures, concomitant arrhythmia surgery, and pacemaker implantation. Methods We reviewed the hospital records of 25 consecutive patients who underwent a Fontan conversion procedure from January 2004 to March 2012. Twenty-four patients had arrhythmia surgery using cryoablation and radiofrequency ablation at the time of conversion. A bilateral atrial maze procedure was performed in 6 patients, right-side maze in 15, and isthmus block in 3. Three patients with a diagnosis of corrected transposition of the great arteries underwent simultaneous pacemaker implantation electively. Results There was no early death and one late death during a mean follow-up period of 21.2 months. Three tachyarrhythmia recurrences developed, and there were 4 occurrences of sinus bradycardia. Five of these patients required postoperative pacemaker implantation. Conclusion The mid-term results of Fontan conversion and arrhythmia surgery in our institute were satisfactory. The occurrence of unexpected postoperative pacemaker requirement was high in the patients who underwent a right atrial or bilateral atrial maze procedure. Pacemaker or lead implantation is recommended for patients planned to undergo a right-side or full maze procedure. |
| Databáze: | OpenAIRE |
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