Impact of pulsatile pulmonary blood flow on cardiopulmonary exercise performance after the Fontan procedureCentral MessagePerspective

Autor: Lukas Klemm, MS, Frank Klawonn, MSc, PhD, Christoph Röhlig, MD, Thibault Schaeffer, MD, Helena Staehler, MS, Paul Philipp Heinisch, MD, PhD, Nicole Piber, MD, Alfred Hager, MD, PhD, Peter Ewert, MD, PhD, Jürgen Hörer, MD, PhD, Masamichi Ono, MD, PhD
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: JTCVS Open, Vol 16, Iss , Pp 811-822 (2023)
Druh dokumentu: article
ISSN: 2666-2736
DOI: 10.1016/j.xjon.2023.08.012
Popis: Objective: To evaluate the exercise capacity in patients following Fontan–Kreutzer, Fontan–Björk, and total cavopulmonary connection (TCPC). Methods: Patients who performed exercise capacity tests at least once after the Fontan procedure between 1979 and 2007 were included. Patients after Fontan–Björk procedure were divided into 2 groups according to the pulmonary blood flow (PBF) pattern: patients with pulsatile PBF and those without. Peak oxygen uptake (VO2) was measured and percent-predicted VO2 was calculated. Results: A total of 227 patients were nominated. The types of Fontan procedure included Fontan–Kreutzer in 48 (21.1%) patients, Fontan–Björk in 38 (16.7%); 11 (4.8%) with pulsatile PBF and 27 (11.9%) without pulsatile PBF; and TCPC in 141 (62.1%). Median age at the Fontan procedure was 4.5 years (interquartile range, 2.1-8.2 years). A total of 978 cardiopulmonary exercise tests were performed at median follow-up of 17.7 years (interquartile range, 11.3-23.4 years) postoperatively. Analysis using linear mixed-effects models demonstrated that percent-predicted VO2 was greater in patients with pulsatile PBF after Fontan–Björk compared with patients after other types of Fontan procedure (P
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