Cardiac surgery Long-term follow-up in adult patients after Fontan operations

Tomkiewicz‐Pająk, Lidia; Hoffman, Piotr; Trojnarska, Olga; Bednarek, Jacek; Płazak, Wojciech; Pająk, Jacek; Olszowska, Maria; Komar, Monika; Podolec, Piotr

doi:10.5114/kitp.2013.39737

Cited by 13 publications

(29 citation statements)

References 28 publications

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“…Our study shows that Fontan patients exhibit a decreased exercise capacity which is in line with previous studies concerning the adult patients with Fontan circulation [12,15,16]. In our group of Fontan patients maximum VO 2 was decreased.…”

Section: Discussionsupporting

confidence: 81%

“…Those observations are in line with our study -we observed a trend towards a decrease of maximum HR and increase of HRR in Fontan patients according to postoperative time. A chronotropic incompetence can be related to an abnormal reflex control of heart rate or adrenergic dysfunction [2,16]. The HR plays an important role in controlling a CO in Fontan circulation during exercise [20].…”

Section: Discussionmentioning

confidence: 99%

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Exercise capacity in adult patients after Fontan procedure. (RCD code: IV-5B.1)

Smaś-Suska

Weryński

Dłużniewska

et al. 2016

Journal of Rare Cardiovascular Diseases

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Background: The aim of Fontan procedure is to restore a balance between pulmonary and systemic circulation and improve or nearly normalize arterial saturation in patients with functionally univentricular heart. Nevertheless, due to the lack of subpulmonary pump, the circulatory system becomes haemodynamically less efficient, what can lead to the impairment of exercise capacity. Aim: The aim of the study was to investigate exercise capacity by means of cardiopulmonary exercise test and pulmonary function tests, of 37 adult Fontan patients with regard to the time passed from the index procedure. The patients were divided into 3 groups: group I -up to 15 years post procedure; group II -16-20 years, group III -more than 20 years after Fontan procedure). Results: 37 Fontan patients (mean age was 24.4 ±5.7 years, 40% of women) were enrolled in the study. The mean postoperative time was 19.4 ±5.1 (13-30) years. Mean, peak oxygen consumption (VO 2peak) was 22.7 ±7.1 ml/kg/min (64.2 ±18.5% of predicted value). According to postoperative time a significant increase of ventilatory equivalent of carbon dioxide (VE/VCO 2 ) (p = 0.033) and significant decrease of forced expiratory volume in 1 s/ vital capacity (FEV 1 %VC) between group 2 and 3 (p = 0.026) were observed. Additionally, the age of the patients correlated negatively with and heart rate (HR) (r = -0.360, p <0.05) and peak oxygen consumption (VO 2peak) (r = -0,337, p < 0.05). Moreover, age at Fontan operation and time after Fontan procedure was related to ventilator equivalent of oxygen (VE/VO 2 ) (r = -0,343, p <0.05, and r = 0.393, p <0.05). Single ventricle ejection fraction (SVEF) and atrioventricular regurgitation degree did not corresponded with cardiopulmonary exercise test (CPET) values. Conclusions: Results highlight the complex problem of diminished exercise capacity of Fontan patients depending on the time passed from the procedure. Exercise tolerance deteriorates in time: VE/VCO 2 increases, FEV1/VC markedly lowers in a group of Fontan patients at 20 years follow-up. JRCD 2016; 2 (8): [254][255][256][257][258]

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Exercise capacity in adult patients after Fontan procedure. (RCD code: IV-5B.1)

Smaś-Suska

Weryński

Dłużniewska

et al. 2016

Journal of Rare Cardiovascular Diseases

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“…Accordingly, long-term antiplatelet therapy for prevention of thrombosis after Fontan operations is a reasonable consideration, even though thrombosis is a common feature (2)(3)(4). However, it is not known whether patients after Fontan operation respond to aspirin and whether aspirin resistance is prevalent in them (11)(12)(13).…”

Section: Accepted Manuscriptmentioning

confidence: 97%

“…The reported incidence of this life-threatening complication in FC patients ranges from 17% to 33% (1,2). The pro-thrombotic risk factors include previous thrombosis, type of arteriopulmonary connection, presence of thrombogenic foreign material, arrhythmias, slow venous flow, elevated central venous pressure, ventricular dysfunction, liver injury, effusion protein-losing enteropathy, and prolonged immobilization (3).…”

Section: Introductionmentioning

confidence: 99%

Aspirin resistance in adult patients after Fontan surgery

Tomkiewicz‐Pająk¹,

Wójcik²,

Chłopicki³

et al. 2015

International Journal of Cardiology

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“…In spite of low early mortality after Fontan procedure, patients are prone to several complications in long term, including arrhythmias, thrombo embolism, heart failure, pulmonary hypertension, cyanosis, liver dysfunction, protein-losing enteropathy, and restrictive lung diseases [5][6][7][8][9][10]. The occurrence of these complications and need for hospitalization influences the life expectancy and emotional, behavioral, and psychosocial condition of these patients.…”

Section: Introductionmentioning

confidence: 99%