Early and Midterm Results of the Extracardiac Fontan Operation and the Change of Internal Diameter of the Conduit

Sung, Si chan; Kim, Si Ho

Abstract

BACKGROUND: Follow-up studies have shown that although outcomes have improved substantially over time,results of the Fontan operation and its modifications remain suboptimal.In this study,we reviewed our experience with the extracardiac conduit Fontan operation,with a focus early and midterm change of internal diameter of PTFE conduit. MATERIAL AND METHOD: Between April 1997 and July 2000 were reviewed.Twelve patients (M:6,F:6,mean age 42.04 +/- 12.43months,mean body weight 13.80 +/- 1.94kg)underwent extracardiac conduit Fontan operation with expanded PTFE graft.Mean cardiopulmonary bypass time was 109.7 +/- 26.99minute and mean operation time was 455 +/- 89.51minute. Intraoperative fenestration was performed in 10 patients.The aortic cross clamping was not performed in all patients. RESULT: There was no early deaths and no postoperative dysrhythmia. Postoperative protein losing enteropathy and prolonged pleural effusion occurred in 1(8.3%)and 4 patients(33.3%).Conduit patency was evaluated by magnetic resonance imaging studies.A 9.84 +/- 3.84%mean reduction in conduit internal diameter and there was no statistical correlation between the change of internal diameter of conduit and the postoperative duration after partial correlation analysis(r=0.019,p=0.955).
CONCLUSION
These results demonstrate that the extracardiac conduit Fontan operation provies good early and midterm results and may reduce the prevalence of late arrhythmia.And there is no correlation between the change of internal diameter of conduit and the postoperative duration after extracardiac conduit Fontan operation with the expanded PTFE graft conduit.