The Fontan operation in infants less than 2 years of age

Howard Weber, Marie M. Gleason, John Myers, John A. Waldhausen, Stephen Cyran, Barry G. Baylen

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Young age remains a reported risk factor for a successful Fontan operation despite improved survival rates. Since March 1978, the Fontan operation has been performed in 47 patients. To avoid a primary or secondary polliative shunt, an early Fontan procedure (Group 1: mean age 1.5 ± 0.5 years, range 0.6 to 2) has been performed in 17 children with the outcome similar to that of the remaining 30 older patients (Group 2: mean age 7.5 ± 5 years, range 2.4 to 23 years). Preoperatively both groups had acceptable hemodynamic status for a successful Fontan result. Operative variables including cardiopulmonary bypass time, aortic cross-clamp time and core temperature were similar between groups and did not affect mortality. The postoperative mortality rate including early surgical (0% vs. 13%, respectively), late (18% vs. 12%) and total (18% vs. 23%) was similar between Groups 1 and 2 (p > 0.05). Immediate postoperative arrhythmias were more frequent in Group 1 (71% vs. 25%, p < 0.01) with no related mortality, while late arrhythmias occurred with equal frequency (29% vs. 39%, p > 0.05). Group 1 infants required a longer hospital stay (22 ± 9 vs. 14 ± 5 days, p < 0.01). Thus, young age is not a risk factor for successful outcome of the Fontan operation in patients with acceptable preoperative hemodynamic status. An early Fontan operation may also avoid prolonged palliative procedures and their potential deleterious effects.

Original languageEnglish (US)
Pages (from-to)828-833
Number of pages6
JournalJournal of the American College of Cardiology
Volume19
Issue number4
DOIs
StatePublished - Mar 15 1992

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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