PMID: 8604934Dec 1, 1995Paper

Modified hemi-Fontan operation: an alternative definitive palliation for high-risk patients

The Annals of Thoracic Surgery
C J Knott-CraigR C Elkins

Abstract

We conceptualized that by adding small amounts of prograde pulmonary blood flow to the hemi-Fontan operation, or bidirectional Glenn procedure, this modified hemi-Fontan operation could be safely done at an early age, with better oxygenation, and with less potential for pulmonary arteriovenous fistulae. Since April 1992 the hemi-Fontan operation was modified by adding some prograde flow through the native pulmonary artery in 10 high-risk infants, either by leaving the critical subpulmonary stenosis untreated (n = 6) or by tightening a previously placed pulmonary artery band (n = 4). All other sources of pulmonary blood flow were interrupted. Patients were 4 to 23 months old (3.8 to 10.3 kg). Diagnoses included isolated dextrocardia with single ventricle (3) and polysplenia syndrome (2). Cardiopulmonary bypass was needed in 5 patients. There were no hospital deaths. Mean postoperative intensive care unit stay was 2 days, and 9 of 10 patients were discharged within 7 days of operation. One 4-month-old infant with Down's syndrome survived postoperative takedown of the hemi-Fontan repair after pneumonia and caval thrombosis developed. Eight patients are currently asymptomatic receiving minimal modification, and oxygen saturations r...Continue Reading

References

Jun 1, 1991·The Annals of Thoracic Surgery·E C DouvilleD A Fyfe
Mar 1, 1989·The Annals of Thoracic Surgery·E MazzeraC Marcelletti
May 1, 1995·The Annals of Thoracic Surgery·V M ReddyF L Hanley
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Citations

Sep 20, 2002·The Annals of Thoracic Surgery·Renate KaulitzGerd Hausdorf
Sep 2, 1998·The Annals of Thoracic Surgery·R M CampbellR M Freedom
Mar 10, 2010·The American Journal of Cardiology·Monesha Gupta-MalhotraJames H Moller
Mar 22, 2008·The Annals of Thoracic Surgery·Davide F CalvarusoCarlo F Marcelletti
Nov 21, 2008·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Alejandro TorresRobert H Pass
Jan 17, 2013·The Journal of Thoracic and Cardiovascular Surgery·Sunita J FernsMichel N Ilbawi
Dec 13, 2000·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·K YamadaE Baudet
Jul 11, 2020·Seminars in Cardiothoracic and Vascular Anesthesia·Ray S ChoiMorgan L Brown
Feb 23, 2021·The Journal of Thoracic and Cardiovascular Surgery·Jae Suk BaekYoung-Hwue Kim
Feb 23, 2021·The Journal of Thoracic and Cardiovascular Surgery·Neel K PrabhuJoseph W Turek

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