@Article{CHD.2020.011671,
AUTHOR = {Carter Biewen, Hitendra Patel, Olaf Reinhartz, Ginny Gildengorin, Natalie Cvijanovich},
TITLE = {A Single Institution’s Experience with Later Extracardiac Fontan Procedure Off Bypass},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {15},
YEAR = {2020},
NUMBER = {4},
PAGES = {229--238},
URL = {http://www.techscience.com/schd/v15n4/40118},
ISSN = {3071-1738},
ABSTRACT = {Purpose: To summarize Fontan procedure data from our institution,
UCSF Benioff Children’s Hospital Oakland, in order to better understand outcomes of our surgical and post-operative care. Basic Procedures: This is a retrospective cross-sectional chart review summarizing characteristics and outcomes of
patients who underwent the Fontan procedure at our institution between 2005 and
2016. Main Findings: Sixty-five Fontan procedures were performed at our institution between 2005 and 2016, all of which were extracardiac Fontan procedures
performed by the same surgical team. At the time of Fontan procedure, the mean
patient age was 56.4 ± 18.7 months and mean weight was 16.6 ± 2.7 kg. There
was no significant correlation appreciated between patient age/weight and outcomes. Six (9%) Fontan conduits were fenestrated. Thirty-eight (58%) Fontan
procedures were performed off cardiopulmonary bypass. Fontan procedures performed off bypass and of shorter duration were associated with fewer days to
extubation and pressor discontinuation post-operatively, as well as higher discharge SpO2. Two patients (3%) required Fontan conduit takedown during their
post-operative ICU stays. The most common complications were pleural effusion,
chylothorax, arrhythmia and infection. There was no early or late mortality.
Principle Conclusions: Delayed extracardiac Fontan procedure off cardiopulmonary bypass appears to be a safe and effective approach. The strategy may
provide benefit when considering certain outcomes, however more studies are
needed to further elucidate these findings.},
DOI = {10.32604/CHD.2020.011671}
}