Total cavopulmonary anastomosis in patients less than three years of age

• Published in: The Annals of thoracic surgery Vol. 60; no. 6; pp. S563 - S567
• Main Authors: Kaulitz, Renate, Ziemer, Gerhard, Luhmer, Ingrid, Paul, Thomas, Kallfelz, Hans C.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.12.1995; Elsevier Science
• Subjects: Biological and medical sciences; Cardiology. Vascular system; Child, Preschool; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Fontan Procedure - methods; Heart; Heart Bypass, Right - methods; Heart Bypass, Right - mortality; Heart Defects, Congenital - physiopathology; Heart Defects, Congenital - surgery; Hemodynamics; Humans; Infant; Medical sciences; Morbidity; Retrospective Studies; Risk Factors; Treatment Outcome; Human; Congenital; Mortality; Surgical anastomosis; Cardiovascular disease; Infant; Cavopulmonary; Result; Treatment; Surgery; Heart disease; Complication; Child; Age; Comparative study
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/0003-4975(95)00856-X

As young age at modified Fontan operation was thought to be a preoperative risk factor for poorer survival, we studied early and intermediate outcome in our young patient group. Results in children less than 3 years of age (group I; n = 26; age range, 7 to 35 months) were compared with those in older patients (group II; n = 46; age range, 36 to 219 months). For both groups there was no significant difference with regard to preoperative pathology and hemodynamics. With an overall mortality of 9.7% (7/72) there was no significant difference for both groups. Group I (n = 23) and group II (n = 42) survivors did not differ with respect to early postoperative incidence of atrial dysrhythmias, duration and volume of pleural effusion, or incidence of reoperation. Results on intermediate follow-up (group I, 31 ± 14 months; group II, 44 ± 20 months) demonstrated a relatively low incidence of late atrial dysrhythmias (12.3%; 8/65). Late atrioventricular valve insufficiency was significantly more frequent in group I patients. With similar preoperative anatomic and hemodynamic parameters including 68% of patients with complex univentricular heart, total cavopulmonary anastomosis could be performed in patients less than 3 years of age with good clinical and hemodynamic results, as achieved in older patients.