A Complete Extracorporeal Circulation-Free Approach to Patients With Functionally Univentricular Hearts Provides Superior Early Outcomes

Abstract

The TCPC without CPB is easy to perform, is cost-effective, and is associated with superior early postoperative outcomes as compared to TCPC on CPB. With appropriate modifications, this operation can be performed in almost all morphological subsets of patients who do not need an associated intracardiac procedure.

Outcomes of Patients Undergoing Primary Fontan Operation Beyond First Decade of Life

“…Since February 2012, patients with a suitable anatomy not requiring intra-cardiac procedures underwent the ECF without CPB. 18…”

Extracardiac Fontan With Direct Inferior Vena Cava to Main Pulmonary Artery Connection Without Cardiopulmonary Bypass

“…3 No interposition graft was used, and therefore, the growth potential is preserved with this kind of connection that may obviate the need for a future conduit replacement. In addition, as we have demonstrated earlier, 7 performing this procedure completely off CPB may avoid the harmful effects of CPB and lead to substantial savings in hospital stay and costs.…”

Perfusion Strategy to Prevent Right Ventricular Decompression on Cardiopulmonary Bypass During Extracardiac Fontan for Right Ventricle–Dependent Coronary Circulation

“…The off-pump Fontan 3 has been successfully applied for final-stage palliation in various single ventricle subtypes and seems rational in situations like PA-IVS with RVDCC where decompression of the right heart is best avoided. Surprisingly, there are very few reports in the literature describing the utilization of the off-pump technique in the highly select subset of patients with PA-IVS 4 and not even one clarifying the presence of RVDCC.…”