TY - JOUR
T1 - Outcomes of one-lung fontan operation
T2 - A retrospective multicenter study in Japan
AU - Fujii, Yasuhiro
AU - Sano, Shunji
AU - Asou, Toshihide
AU - Imoto, Yutaka
AU - Oshima, Yoshihiro
AU - Kawasaki, Shiori
AU - Kishimoto, Hidefumi
AU - Sakamoto, Kisaburo
AU - Maeda, Masanobu
AU - Yamagishi, Masaaki
AU - Matsuo, Kozo
PY - 2012/10
Y1 - 2012/10
N2 - Background: The Fontan operation for patients with one available lung is an extremely challenging situation. However, few reports are available on this procedure. The purpose of this study was to describe outcomes of one-lung Fontan operation. Methods: A retrospective multicenter study was performed. Twelve of 1,142 patients whose data were recorded here underwent one-lung Fontan operation between September 1989 and October 2009. Preoperative, operative, and postoperative data were reviewed. Results: Median age at operation was 3.5 years (range, 1.0 to 22.8), the preoperative mean pulmonary pressure was 11.5 ± 3.3 mm Hg (range, 7.0 to 18.0), the ventricular ejection fraction was 58% ± 13% (range, 39 to 76), and end-diastolic ventricular pressure was 7.5 ± 3.5 mm Hg (range, 1.0 to 12.0). The available lung was right in 9 patients and left in 3 patients. Eleven patients underwent a two-staged Fontan completion. Extracardiac conduit total cavopulmonary connection, intraatrial extracardiac conduit total cavopulmonary connection, and atriopulmonary connection were performed in 10 patients, 1 patient, and 1 patient, respectively. The estimated actuarial survival was 83% at 1year, 73% at 5 years, and 73% at 10 years. Impaired ventricular function was found to be a significant risk factor for mortality by univariate analysis (43.0% ± 9.5% versus 64.0% ± 9.5%, p < 0.01), but not by multivariate analysis. Conclusions: One-lung Fontan operation can be performed with an acceptable midterm to long-term mortality rate in patients without impaired ventricular function. Thus, absence of one lung itself is not a contraindication to the Fontan operation.
AB - Background: The Fontan operation for patients with one available lung is an extremely challenging situation. However, few reports are available on this procedure. The purpose of this study was to describe outcomes of one-lung Fontan operation. Methods: A retrospective multicenter study was performed. Twelve of 1,142 patients whose data were recorded here underwent one-lung Fontan operation between September 1989 and October 2009. Preoperative, operative, and postoperative data were reviewed. Results: Median age at operation was 3.5 years (range, 1.0 to 22.8), the preoperative mean pulmonary pressure was 11.5 ± 3.3 mm Hg (range, 7.0 to 18.0), the ventricular ejection fraction was 58% ± 13% (range, 39 to 76), and end-diastolic ventricular pressure was 7.5 ± 3.5 mm Hg (range, 1.0 to 12.0). The available lung was right in 9 patients and left in 3 patients. Eleven patients underwent a two-staged Fontan completion. Extracardiac conduit total cavopulmonary connection, intraatrial extracardiac conduit total cavopulmonary connection, and atriopulmonary connection were performed in 10 patients, 1 patient, and 1 patient, respectively. The estimated actuarial survival was 83% at 1year, 73% at 5 years, and 73% at 10 years. Impaired ventricular function was found to be a significant risk factor for mortality by univariate analysis (43.0% ± 9.5% versus 64.0% ± 9.5%, p < 0.01), but not by multivariate analysis. Conclusions: One-lung Fontan operation can be performed with an acceptable midterm to long-term mortality rate in patients without impaired ventricular function. Thus, absence of one lung itself is not a contraindication to the Fontan operation.
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U2 - 10.1016/j.athoracsur.2012.04.080
DO - 10.1016/j.athoracsur.2012.04.080
M3 - Article
C2 - 22771056
AN - SCOPUS:84866639174
VL - 94
SP - 1275
EP - 1280
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 4
ER -