Clinical outcomes of Fontan conversion surgery with and without associated arrhythmia intervention

International Journal of Cardiology
Kazuhiro TakahashiJohn K Triedman

Abstract

To characterize mortality and morbidity outcomes in patients undergoing surgical Fontan conversion. Indications for and anticipated clinical outcomes associated with Fontan conversion are controversial. A retrospective single-center cohort study of consecutive patients undergoing Fontan conversion between 1990 and 2006 stratified according to concomitant arrhythmia surgery. Forty patients underwent Fontan conversion at a median age of 19.0 years and were followed for 4.2 years. Six (15%) died, two perioperatively, three early postoperatively, and one following heart transplant. Older age was a univariate risk factor. Major perioperative complications occurred in 9 of 35 (26%) early survivors. Patients with concomitant arrhythmia surgery (N=21) were older at conversion and had longer interoperative intervals. They experienced a reduction in prevalence (95% vs. 28%, P<0.0001) and severity (severity score 7.3 vs. 3.3, P=0.001) of atrial tachyarrhythmias, in contrast to patients without arrhythmia surgery (47% vs. 53%; 3.3 vs. 3.9, P=NS). NYHA functional class improved in both groups. In a subgroup (N=14) with non-urgent late postoperative catheterization, filling pressures were unchanged from preoperative values. Mortality and mor...Continue Reading

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