ArticleInteractive cardiovascular and thoracic surgery2022
Surgical outcomes of reoperation after Fontan completion.
Article in Interactive cardiovascular and thoracic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Early Experience with the First Canadian Paediatric Fontan Long-Term Follow-up Clinic.Pediatric cardiology · 2026Article
- The Long-term Outcomes and Risk Factors of Complications After Fontan Surgery: From the Korean Fontan Registry (KFR).Korean circulation journal · 2024Article
- The effect of the conduit size on middle-term outcomes in patients with extracardiac total cavopulmonary connection.Interdisciplinary cardiovascular and thoracic surgery · 2024Article
- The Fontan procedure is no longer the last operation.Interactive cardiovascular and thoracic surgery · 2022Article
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesPatients who have achieved Fontan circulation may require reoperation. We reviewed the outcomes of reoperation after Fontan completion and assessed the risk factors for poor outcomes.
methodsThis was a retrospective study of 106 patients undergoing open-heart reoperations after Fontan completion in 2003 at a single institution.
resultsThe mean age at reoperation was 24.6 ± 8.3 years. A history of Fontan failure or end-organ dysfunction was noted in 30 patients. The reoperations included 73 total cavopulmonary connection conversions, 29 atrioventricular or semilunar valve operations (17 with total cavopulmonary connection conversions) and 4 other operations. Eight early deaths occurred. During a median follow-up of 5.5 (0.01-16.2) years, there were 3 late deaths and 9 second cardiac operations. The 10-year survival rate after reoperation was 89.8%, and the 5-year second cardiac operation-free survival was 84.3%. The 10-year survival rates were significantly lower in patients who underwent surgery before 2011 (75.8% vs 100%), had a history of Fontan failure or end-organ dysfunction (71.7% vs 97.3%), had preoperative central venous pressure >15 mmHg (64.9% vs 96.5%) and were operated on with deep hypothermic circulatory arrest (DHCA) (60.0% vs 91.3%). A history of Fontan failure or end-organ dysfunction, preoperative central venous pressure >15 mmHg and requirement of DHCA were identified as risk factors for mortality.
conclusionsReoperation after Fontan completion resulted in excellent mid-term outcomes. A history of failed Fontan circulation and the requirement of DHCA negatively affected survival outcomes.
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