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J Thorac Cardiovasc Surg 2006;131:247-249
© 2006 The American Association for Thoracic Surgery

Brief Communication

Intermediate outcomes of fenestrated Fontan procedures

S. Garekar, MD a , * , H.L. Walters, MD b , R.E. Delius, MD b , R.L. Thomas, PhD c , R.D. Ross, MD a

a Division of Cardiology, Children's Hospital of Michigan, Detroit, Mich
b Department of Pediatrics, the Division of Pediatric Cardiovascular Surgery, Children's Hospital of Michigan, Detroit, Mich
c Department of Pediatrics, Children's Hospital of Michigan, Detroit, Mich

Received for publication August 1, 2005; revisions received September 2, 2005; accepted for publication September 8, 2005.

* Address for reprints: Swati Garekar, MD, Pediatric Cardiology, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201 (Email: swatigar@gmail.com).

The first 20% of the full text of this article appears below.

The fenestrated Fontan (FF) procedure is associated with better hemodynamics postoperatively than the modified Fontan procedure without a fenestration. 1,2 Go Although a fenestration improves cardiac output, there is a cost of right-to-left shunting, cyanosis, and the subsequent risk of thromboembolism.

Our goal was to evaluate our experience with FF procedures. Specifically, we sought (1) to assess the outcomes of closed fenestrations, (2) to determine the rate of spontaneously closed fenestrations, and (3), among patients with patent fenestrations, to determine whether a clinical or laboratory variable could be used to predict their outcomes.

After institutional review board approval, 23 FF procedures with no other source of significant right-to-left shunt were identified. The cardiac lesion in the majority of patients (16/23 [70%]) was hypoplastic left heart syndrome.

Pre-Fontan Catheterization Hemodynamics

The average mean pulmonary artery pressure was 11 ± 2.8 mm Hg. The mean pulmonary vascular resistance (PVR) was 2.3 ± 1.5 indexed Wood units. The mean systemic ventricular end-diastolic pressure was 7.8 ± 2.6 mm Hg.

Surgical Results

The mean age at . . . [Full Text of this Article]




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J. W. Salvin, M. A. Scheurer, P. C. Laussen, J. E. Mayer Jr, P. J. del Nido, F. A. Pigula, E. A. Bacha, and R. R. Thiagarajan
Factors Associated With Prolonged Recovery After the Fontan Operation
Circulation, September 30, 2008; 118(14_suppl_1): S171 - S176.
[Abstract] [Full Text] [PDF]


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