Skip to main content
Log in

Is Morbidity Influenced by Staging in the Fontan Palliation? A Single Center Review

  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

In a retrospective study of 32 consecutive patients undergoing a total cavopulmonary connection (TCPC), we tried to determine if the trend for decreasing age at Fontan completion and reducing the intervals between the staged procedures during the past decade was associated with a change in morbidity and outcome. In 8 patients the Fontan circulation was completed in one stage and in 24 patients an intermediate step by hemi-Fontan or bidirectional cavopulmonary anastomosis was performed before Fontan completion. Mean age at TCPC and mean interval since the previous palliation have decreased significantly during the past decade. Although major complications were significantly reduced over time the occurrence and duration of postoperative pleural effusions were not. Decreasing age as well as intervals in staged Fontan palliation have beneficial influence on major complications and outcome, without significantly affecting the duration of pleural effusions at Fontan completion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. EL Bove (1998) ArticleTitleCurrent status of staged reconstruction for hypoplastic left heart syndrome Pediatr Cardiol 19 308–315 Occurrence Handle9636254 Occurrence Handle1:STN:280:DyaK1czgtFGgug%3D%3D

    PubMed  CAS  Google Scholar 

  2. A Castaneda (1992) ArticleTitleFrom Glenn to Fontan. A continuing evolution Circulation 86 IssueIDsuppl II 80–84

    Google Scholar 

  3. A Choussat F Fontan P Besse et al. (1978) Selection criteria for Fontan's procedure RH Anderson EA Shinebourne (Eds) Paediatric Cardiology 1977 Churchill Livingstone Edinburgh, UK 559–566

    Google Scholar 

  4. AD Cochrane CP Brizard DJ Penny et al. (1997) ArticleTitleManagement of the univentricular connection: are we improving? Eur J Cardiothorac Surg 12 107–115 Occurrence Handle9262090 Occurrence Handle10.1016/S1010-7940(97)00112-7 Occurrence Handle1:STN:280:DyaK2svgsVSjtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  5. MR de Leval P Kilner M Gewillig C Bull (1988) ArticleTitleTotal cavopulmonary connection: a logical alternative to atriopulmonary connection for complex Fontan operations J Thorac Cardiovasc Surg 96 682–695 Occurrence Handle3184963 Occurrence Handle1:STN:280:DyaL1M%2FjvVGkuw%3D%3D

    PubMed  CAS  Google Scholar 

  6. F Fontan E Baudet (1971) ArticleTitleSurgical repair of tricuspid atresia Thorax 26 240–248 Occurrence Handle5089489 Occurrence Handle1:STN:280:DyaE3M3ivVCrsw%3D%3D Occurrence Handle10.1136/thx.26.3.240

    Article  PubMed  CAS  Google Scholar 

  7. F Fontan G Fernandez F Costa et al. (1989) ArticleTitleThe size of the pulmonary arteries and the results of the Fontan operation J Thorac Cardiovasc Surg 98 711–724 Occurrence Handle2811408 Occurrence Handle1:STN:280:DyaK3c%2Fkt1CgsA%3D%3D

    PubMed  CAS  Google Scholar 

  8. TY Hsia S Khambadkone AN Redington MR de Leval (2001) ArticleTitleEffect of fenestration on the subdiaphragmatic venous hemodynamics in the total cavopulmonary connection Eur J Cardiothorac Surg 19 785–792 Occurrence Handle11404131 Occurrence Handle10.1016/S1010-7940(01)00705-9 Occurrence Handle1:STN:280:DC%2BD3Mzjs1aktg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  9. RA Jonas (1994) ArticleTitleIndications and timing for the bi-directional Glenn shunt versus the fenestrated Fontan circulation J Thorac Cardiovasc Surg 108 522–524 Occurrence Handle7521499 Occurrence Handle1:STN:280:DyaK2czlvFaltQ%3D%3D

    PubMed  CAS  Google Scholar 

  10. CJ Knott-Craig PR Julsrud HV Schaff FJ Puga GK Danielson (1993) ArticleTitlePulmonary artery size and clinical outcome after the modified Fontan operation Ann Thorac Surg 55 646–651 Occurrence Handle8452427 Occurrence Handle1:STN:280:DyaK3s7pvFeqsw%3D%3D Occurrence Handle10.1016/0003-4975(93)90268-M

    Article  PubMed  CAS  Google Scholar 

  11. PB Manning JE Mayer G Wernovsky SB Fishberger EP Walsh (1996) ArticleTitleStaged operation to Fontan increases incidence of sinoatrial node dysfunction J Thorac Cardiovasc Surg 111 833–840 Occurrence Handle8614144 Occurrence Handle1:STN:280:DyaK287osVemtQ%3D%3D

    PubMed  CAS  Google Scholar 

  12. C Marcelletti A Corno S Giannico B Marino (1990) ArticleTitleInferior vena cava–pulmonary artery extracardiac conduit . A new form of right heart bypass J Thorac Cardiovasc Surg 100 228–232 Occurrence Handle2143549 Occurrence Handle1:STN:280:DyaK3czkvVahsg%3D%3D

    PubMed  CAS  Google Scholar 

  13. M Masuda H Kado Y Shiokawa et al. (1998) ArticleTitleClinical results of the staged Fontan procedure in high-risk patients Ann Thorac Surg 65 1721–1725 Occurrence Handle9647088 Occurrence Handle1:STN:280:DyaK1czgvFejsQ%3D%3D

    PubMed  CAS  Google Scholar 

  14. WI Norwood ML Jacobs (1993) ArticleTitleFontan's procedure in two stages Am J Surg 166 548–551 Occurrence Handle8238751 Occurrence Handle1:STN:280:DyaK2c%2Flslagsg%3D%3D

    PubMed  CAS  Google Scholar 

  15. VM Reddy DB McElhinney P Moore E Petrossian FL Hanley (1996) ArticleTitlePulmonary artery growth after bidirectional cavopulmonary shunt: is there a cause for concern? J Thorac Cardiovasc Surg 112 1180–1192 Occurrence Handle8911314 Occurrence Handle1:STN:280:DyaK2s%2Fmsl2rtA%3D%3D

    PubMed  CAS  Google Scholar 

  16. R Sharma KS Iyer B Airan et al. (1995) ArticleTitleUniventricular repair. Early and midterm results J Thorac Cardiovasc Surg 110 1692–1701 Occurrence Handle8523882 Occurrence Handle1:STN:280:DyaK287gtFOluw%3D%3D

    PubMed  CAS  Google Scholar 

  17. SA Webber P Horvath JG LeBlanc et al. (1995) ArticleTitleInfluence of competitive pulmonary blood flow on the bidirectional superior cavopulmonary shunt, A multi-institutional study. Circulation 92 IssueIDsuppl II 279–286

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to K. Francois.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Francois, K., Tamim, M., Bove, T. et al. Is Morbidity Influenced by Staging in the Fontan Palliation? A Single Center Review. Pediatr Cardiol 26, 350–355 (2005). https://doi.org/10.1007/s00246-005-8646-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-005-8646-2

Keywords

Navigation