A Simple Predictive Factor for Mortality in Fontan Surgery: Serum Hypo-Osmolality

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 35; no. 2; pp. 155 - 159
• Main Authors: Ozbek, Baburhan, Tanrıkulu, Nursen
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Cirurgia Cardiovascular 01.01.2020
• Subjects: CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiac Output; Cardiovascular disease; Coronary vessels; Extracorporeal membrane oxygenation; Exudates and Transudates; Fontan Procedure; Heart surgery; Intubation; Mortality; Original; Osmolar Concentration; Patients; Pleural Effusion; Postoperative Period; Pulmonary arteries; SURGERY; Fontan Procedure; Osmolar Concentration; Pleural Effusion; Mortality; Cardiac Output; Postoperative Period; Exudates and Transudates
• ISSN: 1678-9741; 0102-7638; 1678-9741
• DOI: 10.21470/1678-9741-2019-0325

Close follow-up is important after the Fontan procedure, which is a palliative surgical method for a single ventricle. In this period, serum osmolality is an important parameter with the advantages of easy to obtain and poor outcome prediction. Patients who had undergone Fontan operation between May 2011 and February 2017 were retrospectively evaluated. Patients were divided into three groups based on their serum osmolality values: hypoosmolar (Group 1), isosmolar (Group 2), and hyperosmolar (Group 3). Demographics, clinical information and postoperative data of the groups were compared. Forty-three patients had undergone extracardiac Fontan operation in the study period. There were 8, 19 and 16 patients in Groups 1, 2 and 3, respectively. Among the three groups, postoperative intubation and length of hospital stay, prolonged pleural effusion, need for inotropic support and mortality were statistically significantly higher in Group 1. After the Fontan procedure, one of the determinants of cardiac output might be affected by serum osmolality. Decreased serum osmolality might be associated with poor prognosis after Fontan procedure. Serum osmolality monitoring may be beneficial to improve postoperative outcomes in these patients.