Linked Life Data

2357136

Source:http://linkedlifedata.com/resource/pubmed/id/2357136

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
1990-7-20
pubmed:abstractText
We reviewed our experience in 38 patients who underwent a Fontan operation. In the first five patients ages 7.5 to 23 years (mean, 15 years), a conduit was placed from the right atrium to the small right ventricle or the pulmonary artery (PA). The remaining 33 patients, ages 7 months to 14 years (mean, 4.8 years), had a modified Fontan operation with direct systemic venous or right atrial to PA anastomosis. The diagnoses were tricuspid atresia (n = 14), single ventricle (n = 10), hypoplastic right or left ventricle (n = 9), double-outlet right ventricle with inlet ventricular septal defect and pulmonary atresia or stenosis (n = 3), criss-cross ventricles and transposition of the great arteries (n = 1), and atrioventricular canal and anomalous pulmonary venous connection (n = 1). Thirty-two patients had previous surgery. Other procedures included PA banding (n = 7), systemic to PA shunts (n = 25), Norwood operation (n = 3), and a Damus-Kaye-Stansel anastomosis (n = 1), repair of total anomolous pulmonary venous connection (n = 1), a Blalock-Hanlon atrial septectomy (n = 1), and enlargement of a restrictive ventricular septal defect (n = 1). There were four operative deaths (10.5%), three from low cardiac output and one from subaortic obstruction. There were no deaths in patients younger than 3 years of age (n = 13). Subaortic obstruction developed in six of the seven patients who had pulmonary artery banding and resulted in three deaths. In our experience, diagnosis, previous surgery, type of previous operation, PA pressure, and younger age are not risk factors for early or late death. Subaortic obstruction is a major risk factor for late death. Accordingly we now perform a Damus-Kaye-Stansel anastomosis combined with a systemic to PA shunt in those children with excessive pulmonary blood flow who anatomically are likely to develop subaortic obstruction. A modified Fontan operation can be performed any time after 1 year of age and in some patients after 6 months of age, providing the anatomy and physiology of the patient are acceptable.
pubmed:commentsCorrections
http://linkedlifedata.com/resource/pubmed/commentcorrection/2357136-13226952, http://linkedlifedata.com/resource/pubmed/commentcorrection/2357136-13566431, http://linkedlifedata.com/resource/pubmed/commentcorrection/2357136-2419010, http://linkedlifedata.com/resource/pubmed/commentcorrection/2357136-2801527, http://linkedlifedata.com/resource/pubmed/commentcorrection/2357136-2946901, http://linkedlifedata.com/resource/pubmed/commentcorrection/2357136-2980014, http://linkedlifedata.com/resource/pubmed/commentcorrection/2357136-3184963, http://linkedlifedata.com/resource/pubmed/commentcorrection/2357136-3784586, http://linkedlifedata.com/resource/pubmed/commentcorrection/2357136-4039129, http://linkedlifedata.com/resource/pubmed/commentcorrection/2357136-4518787, http://linkedlifedata.com/resource/pubmed/commentcorrection/2357136-502568, http://linkedlifedata.com/resource/pubmed/commentcorrection/2357136-5089489
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
0003-4932
pubmed:author
pubmed:issnType
Print
pubmed:volume
211
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
738-43; discussion 744
pubmed:dateRevised
2009-11-18
pubmed:meshHeading
pubmed:year
1990
pubmed:articleTitle
A reconsideration of risk factors for the Fontan operation.
pubmed:affiliation
Department of Surgery, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
pubmed:publicationType
Journal Article