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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
5
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pubmed:dateCreated |
1990-12-11
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pubmed:abstractText |
Ventricular dysfunction, elevated pulmonary vascular resistance, and residual distal pulmonary artery distortion contribute to early mortality after a Fontan operation; they may be transient or reversible. A baffle fenestration, allowing right-to-left shunting, maintains cardiac output and limits right atrial pressure. A baffle fenestration was surgically created at the time of a modified Fontan repair in 20 consecutive patients. Risk factors included pulmonary artery pressure of 18 mm Hg or more, end-diastolic pressure of 12 mm Hg or more, valvar regurgitation, pulmonary artery distortion, pulmonary vascular resistance of 2 Woods' units or more, ventricular outflow obstruction, and complex anatomy. Nineteen of 20 patients survived. After the operation, mean arterial oxygen saturation was 86%, mean right atrial pressure was 15 mm Hg, and mean duration of pleural effusions was 6 days. Twelve of 19 survivors tolerated early test occlusion and had permanent transcatheter umbrella closure. Four patients failed early test occlusion, with a significant decrease in venous O2 saturation and a rise in central venous pressure, due to ventricular dysfunction, pulmonary artery distortion, or aortopulmonary collaterals. Three of four had successful late closure of the fenestration after correction of these abnormalities.
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pubmed:commentsCorrections | |
pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
AIM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Nov
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pubmed:issn |
0009-7322
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
82
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
1681-9
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pubmed:dateRevised |
2004-11-17
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pubmed:meshHeading |
pubmed-meshheading:2225370-Cardiac Output,
pubmed-meshheading:2225370-Child,
pubmed-meshheading:2225370-Heart Atria,
pubmed-meshheading:2225370-Heart Catheterization,
pubmed-meshheading:2225370-Heart Defects, Congenital,
pubmed-meshheading:2225370-Humans,
pubmed-meshheading:2225370-Hypertension, Pulmonary,
pubmed-meshheading:2225370-Polytetrafluoroethylene,
pubmed-meshheading:2225370-Postoperative Complications,
pubmed-meshheading:2225370-Prostheses and Implants,
pubmed-meshheading:2225370-Pulmonary Artery,
pubmed-meshheading:2225370-Risk Factors,
pubmed-meshheading:2225370-Vascular Resistance
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pubmed:year |
1990
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pubmed:articleTitle |
Baffle fenestration with subsequent transcatheter closure. Modification of the Fontan operation for patients at increased risk.
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pubmed:affiliation |
Department of Cardiology, Children's Hospital, Boston, Mass 02115.
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pubmed:publicationType |
Journal Article
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