JTCS Tips for Better Browsing
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
John E. Mayer, Jr.
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gentles, T. L.
Right arrow Articles by Wernovsky, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gentles, T. L.
Right arrow Articles by Wernovsky, G.

J Thorac Cardiovasc Surg 1997;114:392-403
© 1997 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

FUNCTIONAL OUTCOME AFTER THE FONTAN OPERATION: FACTORS INFLUENCING LATE MORBIDITY

Thomas L. Gentles , FRACPa*, Kimberlee Gauvreau , ScDa, John E. Mayer , Jr. , MDb, Steven B. Fishberger , MDa**, Janice Burnetta, Steven D. Colan , MDa, Jane W. Newburger , MD, MPHa, Gil Wernovsky , MDa***

K.G. was supported in part by the Kobren Fund.

Received for publication Nov. 5, 1996; revisions requested Jan. 22, 1997 revisions received June 2, 1997; accepted for publication June 2, 1997. Address for reprints: Jane Newburger, MD, Department of Cardiology, Children's Hospital, 300 Longwood Ave., Boston, MA 02115.

Abstract

Objectives: The purpose of this study was to describe the functional outcome of a large number of patients after modifications of the Fontan operation and to investigate perioperative risk factors that might influence late functional state. Methods: A comprehensive cross-sectional review of the first 500 patients undergoing a Fontan operation at our institution was undertaken. Those surviving with an intact Fontan circulation were reviewed by questionnaire to assess functional status and medication history. Medical records, chest roentgenograms, echocardiograms, cardiac catheterizations, and laboratory investigations were also reviewed to assess postoperative status. Results: Three hundred sixty-three long-term survivors with an intact Fontan circulation were identified during cross-sectional follow-up. Median age at operation was 5.0 years (range 0.4 to 31 years), and median follow-up was 5.4 years (range 1.7 to 20 years). Most patients (91.1%) were in New York Heart Association class I or II. In a multivariate model, poor (class III or IV) functional state was associated with longer duration of follow-up ( p < 0.001), a prior atrial septectomy ( p = 0.03), and a prior main pulmonary artery-ascending aorta anastomosis ( p = 0.05). Conclusions: A poor functional outcome is uncommon after the Fontan operation but becomes more frequent with increasing duration of follow-up.




This article has been cited by other articles:


Home page
 Arch Pediatr Adolesc MedHome page
G. Wernovsky
The Paradigm Shift Toward Surgical Intervention for Neonates With Hypoplastic Left Heart Syndrome
Arch Pediatr Adolesc Med, September 1, 2008; 162(9): 849 - 854.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S.-J. Kim, W.-H. Kim, H.-G. Lim, and J.-Y. Lee
Outcome of 200 patients after an extracardiac Fontan procedure
J. Thorac. Cardiovasc. Surg., July 1, 2008; 136(1): 108 - 116.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
A. Giardini, A. Balducci, S. Specchia, G. Gargiulo, M. Bonvicini, and F. M. Picchio
Effect of sildenafil on haemodynamic response to exercise and exercise capacity in Fontan patients
Eur. Heart J., July 1, 2008; 29(13): 1681 - 1687.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
R. J. Sommer, Z. M. Hijazi, and J. F. Rhodes
Pathophysiology of Congenital Heart Disease in the Adult: Part III: Complex Congenital Heart Disease
Circulation, March 11, 2008; 117(10): 1340 - 1350.
[Full Text] [PDF]

Home page
 Card Surg AdultHome page
H. Laks, D. Marelli, M. Plunkett, and J. Myers
Adult Congenital Heart Disease
Card. Surg. Adult, January 1, 2008; 3(2008): 1431 - 1464.
[Full Text]

Home page
 J Am Coll CardiolHome page
K. N. Vogt, C. Manlhiot, G. Van Arsdell, J. L. Russell, S. Mital, and B. W. McCrindle
Somatic Growth in Children With Single Ventricle Physiology: Impact of Physiologic State
J. Am. Coll. Cardiol., November 6, 2007; 50(19): 1876 - 1883.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Ono, D. Boethig, H. Goerler, M. Lange, M. Westhoff-Bleck, and T. Breymann
Somatic development long after the Fontan operation: factors influencing catch-up growth.
J. Thorac. Cardiovasc. Surg., November 1, 2007; 134(5): 1199 - 1206.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. Schreiber, J. Horer, M. Vogt, J. Cleuziou, Z. Prodan, and R. Lange
Nonfenestrated Extracardiac Total Cavopulmonary Connection in 132 Consecutive Patients
Ann. Thorac. Surg., September 1, 2007; 84(3): 894 - 899.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
C. E. Canter, R. E. Shaddy, D. Bernstein, D. T. Hsu, M. R.K. Chrisant, J. K. Kirklin, K. R. Kanter, R. S.D. Higgins, E. D. Blume, D. N. Rosenthal, et al.
Indications for Heart Transplantation in Pediatric Heart Disease: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young; the Councils on Clinical Cardiology, Cardiovascular Nursing, and Cardiovascular Surgery and Anesthesia; and the Quality of Care and Outcomes Research Interdisciplinary Working Group
Circulation, February 6, 2007; 115(5): 658 - 676.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
M. Ono, D. Boethig, H. Goerler, M. Lange, M. Westhoff-Bleck, and T. Breymann
Clinical outcome of patients 20 years after Fontan operation -- effect of fenestration on late morbidity
Eur. J. Cardiothorac. Surg., December 1, 2006; 30(6): 923 - 929.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
H. Senzaki, S. Masutani, H. Ishido, M. Taketazu, T. Kobayashi, N. Sasaki, H. Asano, T. Katogi, S. Kyo, and Y. Yokote
Cardiac Rest and Reserve Function in Patients With Fontan Circulation
J. Am. Coll. Cardiol., June 20, 2006; 47(12): 2528 - 2535.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
S. Giannico, F. Hammad, A. Amodeo, G. Michielon, F. Drago, A. Turchetta, R. Di Donato, and S. P. Sanders
Clinical Outcome of 193 Extracardiac Fontan Patients: The First 15 Years
J. Am. Coll. Cardiol., May 16, 2006; 47(10): 2065 - 2073.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. E. Mitchell, R. F. Ittenbach, J. W. Gaynor, G. Wernovsky, S. Nicolson, and T. L. Spray
Intermediate outcomes after the Fontan procedure in the current era
J. Thorac. Cardiovasc. Surg., January 1, 2006; 131(1): 172 - 180.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
U. Fakler, C. Pauli, M. Hennig, W. Sebening, and J. Hess
Assumed oxygen consumption frequently results in large errors in the determination of cardiac output
J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 272 - 276.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. N. Kavarana, S. Pagni, M. R. Recto, W. L. Sobczyk, T. Yeh Jr, M. Mitchell, and E. H. Austin III
Seven-Year Clinical Experience With the Extracardiac Pedicled Pericardial Fontan Operation
Ann. Thorac. Surg., July 1, 2005; 80(1): 37 - 43.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. H. Nurnberg, S. Ovroutski, V. Alexi-Meskishvili, P. Ewert, R. Hetzer, and Peter. E. Lange
New Onset Arrhythmias After the Extracardiac Conduit Fontan Operation Compared With the Intraatrial Lateral Tunnel Procedure: Early and Midterm Results
Ann. Thorac. Surg., December 1, 2004; 78(6): 1979 - 1988.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. I. Cohen, L. A. Rhodes, T. L. Spray, and J. W. Gaynor
Efficacy of prophylactic epicardial pacing leads in children and young adults
Ann. Thorac. Surg., July 1, 2004; 78(1): 197 - 202.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. Weipert, C. Noebauer, C. Schreiber, M. Kostolny, B. Zrenner, A. Wacker, J. Hess, and R. Lange
Occurrence and management of atrial arrhythmia after long-term Fontan circulation
J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 457 - 464.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. J. Bradley, D. G. Human, J.A. G. Culham, W. J. Duncan, M. W. H. Patterson, J. G. LeBlanc, and S. S. Sett
Clipped tube fenestration after extracardiac Fontan allows for simple transcatheter coil occlusion
Ann. Thorac. Surg., December 1, 2003; 76(6): 1923 - 1928.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
J. R. Lee, J. S. Choi, C. H. Kang, E. J. Bae, Y. J. Kim, and J. R. Rho
Surgical results of patients with a functional single ventricle
Eur. J. Cardiothorac. Surg., November 1, 2003; 24(5): 716 - 722.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. P. Kumar, C. S. Rubinstein, J. M. Simsic, A. B. Taylor, J. P. Saul, and S. M. Bradley
Lateral tunnel versus extracardiac conduit fontan procedure: a concurrent comparison
Ann. Thorac. Surg., November 1, 2003; 76(5): 1389 - 1397.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. Elefteriades, C. Lovoulos, R. Edwards, S. Tittle, T. Riley, P. Tang, E. Rocco, and G. Kopf
Novel technique for isolated accessory right heart transplantation for congenital heart disease
J. Thorac. Cardiovasc. Surg., June 1, 2003; 125(6): 1283 - 1290.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
H. Laks, D. Marelli, M. Plunkett, J. Odim, and J. Myers
Adult Congenital Heart Disease
Card. Surg. Adult, January 1, 2003; 2(2003): 1329 - 1358.
[Full Text]

Home page
 Eur. J. Cardiothorac. Surg.Home page
G. Stellin, V.L. Vida, O. Milanesi, M. Rubino, M.A. Padalino, S. Secchieri, G. Pittarello, and D. Casarotto
Surgical treatment of complex cardiac anomalies: the 'one and one half ventricle repair'
Eur. J. Cardiothorac. Surg., December 1, 2002; 22(6): 1043 - 1049.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. Kaulitz, G. Ziemer, T. Paul, M. Peuster, H. Bertram, and G. Hausdorf
Fontan-type procedures: residual lesions and late interventions
Ann. Thorac. Surg., September 1, 2002; 74(3): 778 - 785.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
G. Stellin, V.L. Vida, O. Milanesi, M. Rubino, M.A. Padalino, S. Secchieri, G. Pittarello, and D. Casarotto
Surgical treatment of complex cardiac anomalies: the 'one and one half ventricle repair'
Eur. J. Cardiothorac. Surg., September 1, 2002; 22(3): 431 - 437.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
H. Senzaki, S. Masutani, J. Kobayashi, T. Kobayashi, N. Sasaki, H. Asano, S. Kyo, Y. Yokote, and A. Ishizawa
Ventricular Afterload and Ventricular Work in Fontan Circulation: Comparison With Normal Two-Ventricle Circulation and Single-Ventricle Circulation With Blalock-Taussig Shunts
Circulation, June 18, 2002; 105(24): 2885 - 2892.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
F. Lacour-Gayet, C. Haun, K. Ntalakoura, E. Belli, L. Houyel, P. Marcsek, F. Wagner, and J. Weil
Biventricular repair of double outlet right ventricle with non-committed ventricular septal defect (VSD) by VSD rerouting to the pulmonary artery and arterial switch
Eur. J. Cardiothorac. Surg., June 1, 2002; 21(6): 1042 - 1048.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
B. Voss, F.-U. Sack, W. Saggau, S. Hagl, and R. Lange
Atrial cardiomyoplasty in a Fontan circulation
Eur. J. Cardiothorac. Surg., May 1, 2002; 21(5): 780 - 786.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
A. Serraf, D. Piot, E. Belli, F. Lacour-Gayet, A. Touchot, R. Roussin, J. Zoghbi, J. Bruniaux, and C. Planche
Biventricular repair of transposition of the great arteries and unbalanced ventricles
J. Thorac. Cardiovasc. Surg., December 1, 2001; 122(6): 1199 - 1207.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
A P SALMON
Hypoplastic left heart syndrome---outcome and management
Arch. Dis. Child., December 1, 2001; 85(6): 450 - 451.
[Full Text] [PDF]

Home page
 CirculationHome page
J. M. Forbess, K. J. Visconti, D. C. Bellinger, and R. A. Jonas
Neurodevelopmental Outcomes in Children After the Fontan Operation
Circulation, September 18, 2001; 104 (2009): I-127 - I-132.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. Azakie, B. W. McCrindle, L. N. Benson, G. S. Van Arsdell, J. L. Russell, J. G. Coles, D. Nykanen, R. M. Freedom, and W. G. Williams
Total cavopulmonary connections in children with a previous Norwood procedure
Ann. Thorac. Surg., May 1, 2001; 71(5): 1541 - 1546.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. I. Cohen, V. L. Vetter, G. Wernovsky, D. M. Bush, J. W. Gaynor, V. R. Iyer, T. L. Spray, R. E. Tanel, and L. A. Rhodes
Epicardial pacemaker implantation and follow-up in patients with a single ventricle after the Fontan operation
J. Thorac. Cardiovasc. Surg., April 1, 2001; 121(4): 804 - 811.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
Y. Naito, K. Fujiwara, H. Komai, and S. Uemura
Midterm results after ventricular septation for double-inlet left ventricle in early infancy
Ann. Thorac. Surg., April 1, 2001; 71(4): 1344 - 1346.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
W. Tworetzky, D. B. McElhinney, V. M. Reddy, M. M. Brook, F. L. Hanley, and N. H. Silverman
Improved Surgical Outcome After Fetal Diagnosis of Hypoplastic Left Heart Syndrome
Circulation, March 6, 2001; 103(9): 1269 - 1273.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T.-Y. Hsia, S. Khambadkone, J. E. Deanfield, J. F. N. Taylor, F. Migliavacca, and M. R. de Leval
Subdiaphragmatic venous hemodynamics in the Fontan circulation
J. Thorac. Cardiovasc. Surg., March 1, 2001; 121(3): 436 - 447.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
C. Stamm, I. Friehs, J. E. Mayer Jr, D. Zurakowski, J. K. Triedman, A. M. Moran, E. P. Walsh, J. E. Lock, R. A. Jonas, and P. J. del Nido
Long-term results of the lateral tunnel Fontan operation
J. Thorac. Cardiovasc. Surg., January 1, 2001; 121(1): 0028 - 41.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. P.R. Brizard, N. Goussef, J. C. Chachques, and A. F. Carpentier
Model of complete separation of the hepatic veins from the systemic venous system
Ann. Thorac. Surg., December 1, 2000; 70(6): 2096 - 2101.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
G. Wernovsky, K. M. Stiles, K. Gauvreau, T. L. Gentles, A. J. duPlessis, D. C. Bellinger, A. Z. Walsh, J. Burnett, R. A. Jonas, J. E. Mayer Jr, et al.
Cognitive Development After the Fontan Operation
Circulation, August 22, 2000; 102(8): 883 - 889.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
K. Bando, M. W. Turrentine, H. J. Park, T. G. Sharp, V. Scavo, and J. W. Brown
Evolution of the Fontan procedure in a single center
Ann. Thorac. Surg., June 1, 2000; 69(6): 1873 - 1879.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. S. Mosca, T. J. Kulik, C. S. Goldberg, R. P. Vermilion, J. R. Charpie, D. C. Crowley, and E. L. Bove
EARLY RESULTS OF THE FONTAN PROCEDURE IN ONE HUNDRED CONSECUTIVE PATIENTS WITH HYPOPLASTIC LEFT HEART SYNDROME
J. Thorac. Cardiovasc. Surg., June 1, 2000; 119(6): 1110 - 1118.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
Y F Cheung, D J Penny, and A N Redington
Serial assessment of left ventricular diastolic function after Fontan procedure
Heart, April 1, 2000; 83(4): 420 - 424.
[Abstract] [Full Text]

Home page
 HeartHome page
M A Gatzoulis, M-D Munk, W G Williams, and G D Webb
Definitive palliation with cavopulmonary or aortopulmonary shunts for adults with single ventricle physiology
Heart, January 1, 2000; 83(1): 51 - 57.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
R Kaulitz, P Bergman, I Luhmer, T Paul, and G Hausdorf
Instantaneous pressure-flow velocity relations of systemic venous return in patients with univentricular circulation
Heart, September 1, 1999; 82(3): 294 - 299.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
E. Belli, A. Serraf, F. Lacour-Gayet, M. Hubler, J. Zoghby, L. Houyel, and C. Planche
Double-outlet right ventricle with non-committed ventricular septal defect
Eur. J. Cardiothorac. Surg., June 1, 1999; 15(6): 747 - 752.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. J. Lamberti and K. C. Uzark
The Fontan operation
Ann. Thorac. Surg., May 1, 1999; 67(5): 1523 - 1524.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. E. Cyran
COMMENTARY: FUNCTIONALITY AFTER THE FONTAN PROCEDURE--PERCEIVED REALITY AND THE PONDERING PRINCE
J. Thorac. Cardiovasc. Surg., September 1, 1997; 114(3): 404 - 405.
[Full Text]

Home page
 CirculationHome page
H. Akintuerk, I. Michel-Behnke, K. Valeske, M. Mueller, J. Thul, J. Bauer, K.-J. Hagel, J. Kreuder, P. Vogt, and D. Schranz
Stenting of the Arterial Duct and Banding of the Pulmonary Arteries: Basis for Combined Norwood Stage I and II Repair in Hypoplastic Left Heart
Circulation, March 5, 2002; 105(9): 1099 - 1103.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1997 by The American Association for Thoracic Surgery.