An international multicenter study comparing arrhythmia prevalence between the intracardiac lateral tunnel and the extracardiac conduit type of Fontan operations

Balaji, Seshadri; Daga, Ankana; Bradley, David J.; Etheridge, Susan P.; Law, Ian H.; Batra, Anjan S.; Sanatani, Shubhayan; Singh, Anoop; Gajewski, Kelly K.; Tsao, Sabrina; Singh, Harpreet; Tisma-Dupanovic, Svjetlana; Tateno, Shigeru; Takamuro, Motoki; Nakajima, Hiromichi; Roos‐Hesselink, Jolien W.; Shah, Maully J.

doi:10.1016/j.jtcvs.2013.08.070

Cited by 69 publications

(52 citation statements)

References 16 publications

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“…The incidence of supraventricular tachycardia is higher in patients with atriopulmonary connection type of Fontan because of the progressive dilatation of their atrial cavity. It seems that patients with an extra-cardiac conduit might have a lower incidence of dysrhythmias than those with a lateral tunnel [47,79,80]. …”

Section: Burden Of Diseasementioning

confidence: 99%

Current Therapy for Hypoplastic Left Heart Syndrome and Related Single Ventricle Lesions

2016

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Universally fatal only four decades ago, the progress in the three-stage palliation of hypoplastic left heart syndrome and related single right ventricular lesions has drastically improved the outlook for these patients. While the stage II operation (hemi-Fontan or bidirectional Glenn) and stage III Fontan procedure have evolved into relatively low risk operations, the stage I Norwood procedure remains one of the highest risk and costliest common operations performed in congenital heart surgery. Yet, despite this fact, experienced centers now report hospital survivals in excess of 90% for the Norwood. This traditional three-stage surgical palliation has seen several innovations in the past decade aimed at improving outcomes, particularly for the Norwood procedure. One significant change is a renewed interest in the right ventricle-to-pulmonary artery shunt as the source of pulmonary blood flow, rather than the modified Blalock-Taussig shunt for the Norwood. The multi-institutional Single Ventricle Reconstruction trial randomized 555 patients to one or the other shunt, and these subjects continue to be followed closely as they now approach 10 years post-randomization. In addition to modifications to the Norwood procedure, the “hybrid procedure,” a combined catheter-based and surgical approach, avoids the Norwood procedure in the newborn period entirely. The initial hybrid procedure is then followed by a “comprehensive” stage II, that combines components of both the Norwood and the traditional stage II, and later completion of the Fontan. Proponents of this approach hope to not only improve short-term survival, but potentially longer-term outcomes, such as neurodevelopment, as well. Regardless of the approach, traditional surgical staged palliation or the hybrid procedure, survivals have vastly improved, and large numbers of these patients are surviving not only through their Fontan in early childhood, but into adolescence and young adulthood. As this population grows, it becomes increasingly important to understand the longer-term outcomes of these Fontan patients, not only in terms of survival, but also burden of disease, neurodevelopmental outcomes, psychosocial development and quality of life.

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Section: Burden Of Diseasementioning

confidence: 99%

Current Therapy for Hypoplastic Left Heart Syndrome and Related Single Ventricle Lesions

2016

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“…16 The surgical background of Fontan patients with tachycardia arising from the PVA in the present study was characterized primarily by EC conduit repair. Although data suggest that patients with EC Fontan operation continue to be at risk for supraventricular arrhythmia, 17,18 it is likely that the spectrum of arrhythmia mechanisms in this population will be of greater variability and more often include congenital reciprocating rhythms associated with complex single-ventricle lesions. Because current data on the optimal approach for gaining access to the PVA in the setting of prior EC Fontan operation are limited, 11,19,20 the present study lends support to a direct puncture approach.…”

Section: Single Ventricle Congenital Heart Diseasementioning

confidence: 99%

Catheter ablation of tachycardia arising from the pulmonary venous atrium after surgical repair of congenital heart disease

et al. 2015

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“…Despite the various modifications of the Fontan surgery, including lateral caval tunnel and extracardiac conduits, as well as revisions and primary maze interventions, tachyarrhythmia persists (15). The treatment of AFF in this population is difficult.…”

Section: Introductionmentioning

confidence: 99%

The Risk of Thromboembolic Complications in Fontan Patients with Atrial Flutter/Fibrillation Treated with Electrical Cardioversion

2016

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An international multicenter study comparing arrhythmia prevalence between the intracardiac lateral tunnel and the extracardiac conduit type of Fontan operations

Cited by 69 publications

References 16 publications

Current Therapy for Hypoplastic Left Heart Syndrome and Related Single Ventricle Lesions

Current Therapy for Hypoplastic Left Heart Syndrome and Related Single Ventricle Lesions

Catheter ablation of tachycardia arising from the pulmonary venous atrium after surgical repair of congenital heart disease

The Risk of Thromboembolic Complications in Fontan Patients with Atrial Flutter/Fibrillation Treated with Electrical Cardioversion

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