Fontan Circulation in the Treatment of Complex Congenital Cardiac Abnormalities

Atilla SEZGİN, Ali KUTSAL, Öz KAHRAMANYOL, Afşin YAVERİ, Gülnaz ARSLAN, Enver EKİCİ, Coşkun İKİZLER

Başkent Üniversitesi Tıp Fakültesi

Fontan circulation was performed in 22 patients with complex congenital cardiac abnormali lies during the period between 1989-1994 in the Department of Cardiovascular Surgery at Başkent University Hospital. 7 of them had tricuspid atresia, and 15 of them had different complex cardiac abnormalities. Previous Blalock-Taussig shunt operation was performed in 4 patients because of decreased pulmonary blood flow.

Atrio-pulmonary anastomosis was created in 12, atrio-ventricular in 2 and total cavo pul monary anastomosis in 8 patients. Right atrioventricular valve had been closed by a patch in 4, and primarily by suturing in 2 patients. Fenestration was performed 1 in 5 patients.

Pleural effusion had occured in 9 (40%), significant atrio-ventricular valv regurgilation in 1, and structure at the anastomotic site of the right atrial to pulmonary artery anastomosis in 1 patient.

Mean hospital stay was 17 days. The hospital mortality was 14% with one patient in tricuspid atresia, and 20% with 3 patients in complex anomalies. Late mortality was 18% with 4 patients.

Fontan circulation has provided a satifactory solution in patients who have complex congenital cardiac abnormalities and don't have the enhance of biatrial or biventricular repair.

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