Abstract
This study aimed to describe the learning curve of the extracardiac Fontan procedure in a single center and to analyze the changes in clinical applications and outcomes. A retrospective chart review of all extracardiac Fontan patients in a single tertiary care center was undertaken. Patients with a diagnosis of hypoplastic left heart syndrome and those who had undergone a lateral tunnel modification, intra/extracardiac Fontan, Kawashima procedure, or inferior vena cava-to-azygous vein connection were excluded from the analysis. Between May 2004 and February 2018, data of 159 extracardiac Fontan patients were analyzed. The median age was 5.5 years (range 4.5-8.2 years). Based on a cumulative sum analysis, a hinge point was determined to divide the cohort into 2 phases. Phase 1 ( n = 70) represented the first learning phase and phase 2 ( n = 89) represented the later phase. Mortality decreased in phase 2 (2/89; 2%) compared to phase 1 (10/70; 14%; p = 0.004). Two (3%) patients had extracorporeal membrane oxygenation in phase 1, and 5 (6%) in phase 2 ( p = 0.47). More patients in phase 2 underwent a prior bidirectional Glenn procedure (83/89 vs. 57/70; p = 0.02), fenestration (80/89 vs. 9/70; p < 0.001), and pulmonary artery recon...Continue Reading
References
Oct 1, 1994·The Annals of Thoracic Surgery·M L Jacobs, W I Norwood
Apr 15, 1993·The American Journal of Cardiology·A K PridjianE L Bove
May 1, 1997·Pediatric Cardiology·J A QuinonesE A Fisher
Jul 1, 1998·The Annals of Thoracic Surgery·M MasudaH Yasui
May 8, 2000·The Annals of Thoracic Surgery·M L Jacobs, J E Mayer
Jan 16, 2002·Circulation·Matthew S LemlerClaudio Ramaciotti
Dec 2, 2004·The Journal of Thoracic and Cardiovascular Surgery·Chris A RogersGianni D Angelini
Jun 28, 2005·The American Journal of Cardiology·Joseph R CavaJames S Tweddell
Aug 3, 2007·Interactive Cardiovascular and Thoracic Surgery·Yoshihisa TanoueRyuji Tominaga
Apr 9, 2009·Interactive Cardiovascular and Thoracic Surgery·Yorikazu HaradaSatoshi Yasukouchi
May 30, 2009·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Enrique RuizChristian Brizard
Aug 19, 2011·Journal of Cardiac Surgery·Su Wan KimHeung-Jae Lee
Oct 16, 2014·Annals of Biomedical Engineering·Maria RestrepoAjit Yoganathan
Aug 10, 2015·The Journal of Thoracic and Cardiovascular Surgery·Nancy A PikeVaughn A Starnes
Dec 25, 2015·Heart, Lung & Circulation·Igor E KonstantinovYves d'Udekem
Dec 1, 2013·Journal of Echocardiography·Wei HuiHashim Abdul-Khaliq
Jun 3, 2017·Journal of Cardiac Surgery·Tai FuchigamiKenji Yamazaki
Jan 18, 2018·Journal of Cardiovascular Translational Research·Phillip M TrustyAjit P Yoganathan