ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
LONG-TERM RESULTS OF MODIFIED FONTAN PROCEDURES (RIGHT HEART BYPASS OPERATIONS)
Kaan KIRALİ, Suat Nail ÖMEROĞLU, Denyan MANSUROĞLU, Murat Bülent RABUŞ, Nihan KAYALAR, Mehmet BALKANAY, Gökhan İPEK, Ömer IŞIK, Cevat YAKUT
Koşuyolu Kalp Eğitim ve Araştırma Hastanesi, Kalp Damar Cerrahisi Bölümü, İSTANBUL
Background: Fontan operations are used for the surgical treatment of tricuspid atresia and univentricular congenital heart anomalies. The main goal of these procedures is to achieve systemic venous return into the pulmonary circulation and the normal systemic circulation. The purpose of this study is to determine long-term results of these operations.

Methods: Fontan procedures were performed in 9 patients. Five patients were female and four patients were male. Two patients were younger than 1 year, while the other 7 patients were equal or older than 5 years (range 5 to 22 years; mean 12.4 ± 6.9 years). Surgical indications were tricuspid atresia (33.3%), double-outlet right ventricle (33.3%), double-inlet right ventricle (11.1%), double-inlet left ventricle (11.1%) and single atrium and ventricle with right atrial isomerism (11.1%). The associated cardiac anomalies were ASD, VSD, PS, and TGA. Blalock-Taussig shunt had been performed in two patients (22.2%). Tricuspid valve was closed with a patch. Total cavapulmonary connection was performed in two patients and atriopulmonary connection was performed in seven patients.

Results: Two babies and the thirth 5-year old patient died because of the heart failure. Mortality rate was 33.3% and cumulative survival was 66.67% ± 15.71% at 4 years. Mortality rate was 100% for patients younger than 5 years, whereas it was 14.3% with one patient for patients equal or older than 5 years. Cumulative survival for patients older than 5 years was 85.71% ± 13.23% at 5 years. There was no late mortality or morbidity.

Conclusions: Fontan operations in patients with ideal criteria can be performed with lower mortality and higher survival rate, and with the improvement of quality of life.

Keywords : Fontan, tricuspid atresia, atriopulmonary, total cavapulmonary, single ventricle
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