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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
6
|
| pubmed:dateCreated |
1986-12-31
|
| pubmed:abstractText |
One hundred two patients, aged 0.7 to 38 years, with a wide variety of cardiac malformations underwent the Fontan operation (1975 to April, 1985). Several different techniques were used. All but 17 had previously undergone one or more palliative operations. Follow-up information was obtained in all patients. Overall actuarial survival rate, with time zero being the time of the operation, was 63% at 6 years with no deaths after that in patients followed as long as out to 9.4 years; that for patients with tricuspid atresia was 81%. The hazard function (instantaneous risk) for death was highest immediately after operation and merged after about 6 months with a constant hazard extending as long as the patients were followed. Elevated post-repair right atrial pressure was correlated (p = 0.002) with the probability of death in the early phase, with the risk rising rapidly with pressures above 14 mm Hg. Hypertrophy of the ventricular main chamber was a risk factor for death in both the early (p = 0.007) and late (p = 0.008) phases of hazard, which explained in part the lesser risk of the Fontan operation in patients with tricuspid atresia. Younger age, but not older age, was a risk factor for early postoperative death, but this risk was neutralized by recent date of operation. Thus currently there is not a predicted increased risk associated with younger age at operation. In general, the Fontan operation should be done at a young age (2 to 4 years) to avoid increasing ventricular hypertrophy, but older age per se is not a contraindication to the operation.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
AIM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Dec
|
| pubmed:issn |
0022-5223
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
92
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
1049-64
|
| pubmed:dateRevised |
2004-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:2946901-Actuarial Analysis,
pubmed-meshheading:2946901-Adolescent,
pubmed-meshheading:2946901-Adult,
pubmed-meshheading:2946901-Age Factors,
pubmed-meshheading:2946901-Cardiac Surgical Procedures,
pubmed-meshheading:2946901-Cardiomegaly,
pubmed-meshheading:2946901-Child,
pubmed-meshheading:2946901-Child, Preschool,
pubmed-meshheading:2946901-Heart Defects, Congenital,
pubmed-meshheading:2946901-Humans,
pubmed-meshheading:2946901-Infant,
pubmed-meshheading:2946901-Reoperation,
pubmed-meshheading:2946901-Risk,
pubmed-meshheading:2946901-Time Factors
|
| pubmed:year |
1986
|
| pubmed:articleTitle |
The Fontan operation. Ventricular hypertrophy, age, and date of operation as risk factors.
|
| pubmed:publicationType |
Journal Article
|