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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 392-403 |
| Number of pages | 12 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Volume | 114 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jan 1 1997 |
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All Science Journal Classification (ASJC) codes
- Surgery
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine
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Functional outcome after the Fontan operation : Factors influencing late morbidity. / Gentles, T. L.; Gauvreau, K.; Mayer, Jr; Fishberger, S. B.; Burnett, J.; Colan, S. D.; Newburger, J. W.; Wernovsky, G.; Cyran, Stephen.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 114, No. 3, 01.01.1997, p. 392-403.Research output: Contribution to journal › Article
TY - JOUR
T1 - Functional outcome after the Fontan operation
T2 - Factors influencing late morbidity
AU - Gentles, T. L.
AU - Gauvreau, K.
AU - Mayer, Jr
AU - Fishberger, S. B.
AU - Burnett, J.
AU - Colan, S. D.
AU - Newburger, J. W.
AU - Wernovsky, G.
AU - Cyran, Stephen
PY - 1997/1/1
Y1 - 1997/1/1
N2 - 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.
AB - 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.
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U2 - 10.1016/S0022-5223(97)70184-3
DO - 10.1016/S0022-5223(97)70184-3
M3 - Article
VL - 114
SP - 392
EP - 403
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 3
ER -