Comparison of extracardiac conduit and lateral tunnel for functional single-ventricle patients: A meta-analysis

Lin, Zhiyong; Ge, Hanwei; Xue, Jiyang; Wu, Guowei; Du, Jie; Hu, Xiuying; Zhao, Qifeng

doi:10.1111/chd.12503

Cited by 10 publications

(4 citation statements)

References 54 publications

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“…Available data indicate that it is often necessary to implant a pacemaker in patients undergoing TCPC compared to patients undergoing APC [24,25]. However, a team from Boston demonstrated that the incidence of arrhythmia and pacemaker implantation was not significantly different between patients undergoing TCPC and APC patients.…”

Section: Discussionmentioning

confidence: 99%

Chronotropic incompetence causes multiple organ complications in adults after the Fontan procedure

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Chronotropic incompetence causes multiple organ complications in adults after the Fontan procedure

et al. 2021

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“…The size of the fenestration was decided on the basis of the preoperative hemodynamics and the surgeon's preferences. Extracardiac Fontan (ECF) is known to be more effective than intraatrial lateral tunnel (IALT) in terms of reducing postoperative complications, hospital stay, and atrial arrhythmia [14]. Recently, a newer technical modification, IECF, was introduced with the goal of combining the benefits of IALT and ECF.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Fontan Completion in Adult Patients with Functionally Univentricular Hearts

Alpat,

Aydin,

Aykan

et al. 2024

Thorac Cardiovasc Surg

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Background: Although there are considerable amounts of data on the outcomes of pediatric patients who have undergone Fontan repair, little is known about having Fontan completed in adulthood. The study presented the midterm results of our unit's experience with the Fontan completion procedure in adult patients with functionally univentricular hearts. Methods: Between 2014-2023, 16 adult patients underwent total cavopulmonary connection completion. Relevant information was retrospectively collected. Results: 16 patients with a median age of 19 years (18–21 years) were included. Median arterial oxygen saturation was 76% (70–80.75%), and 62.5% of the patients were NYHA Class-III. The median mean pulmonary artery pressure was 14 mmHg (9.5–14.5 mmHg). Nine patients (56%) had heterotaxy syndrome, and the median time between the last operation and total cavopulmonary connection was 15.5 years (6.75–17.5 years). The median durations for bypass and cross clamp were 160 minutes (130–201 minutes) and 120 minutes (84.5–137.5 minutes), consecutively. The postoperative course was straightforward in all. The median arterial oxygen saturation before discharge was 89.5 % (85-90%), and 68.75% of the patients were NYHA Class-II. Follow-up was complete for all patients with a median of 24 months. There was no early or late mortality or significant morbidity during the study period. Conclusions: We concluded that the intra-extracardiac fontan technique was feasible for meticulously selected adults undergoing total cavopulmonary connection completion, as evidenced by an acceptable mortality rate and a satisfactory mid-term outcome, including improvements in their NYHA functional class. However, the long-term consequences must be monitored.

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“…Supraventricular tachycardia (SVT) contributes significantly to late mortality in Fontan patients 32 . SVT has been associated with Fontan type; the highest risk is for APC type, followed by ILT, and the lowest is for ECC 23 , 33 . Results may have improved for the ILT technique after introduction of the prosthetic modification 34 .…”

Section: State Of the Artmentioning

confidence: 99%

“…A contemporary Fontan strategy uses either the ILT or the ECC modification. Two large meta-analyses have recently compared surgical strategies and found no differences in early or late mortality and Fontan takedown between ECC and ILT 33 , 149 . Theoretical advantages of both techniques have been discussed extensively in the literature 150 , 151 .…”

Section: Remaining Challengesmentioning

confidence: 99%

State of the art of the Fontan strategy for treatment of univentricular heart disease

et al. 2018

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In patients with a functionally univentricular heart, the Fontan strategy achieves separation of the systemic and pulmonary circulation and reduction of ventricular volume overload. Contemporary modifications of surgical techniques have significantly improved survival. However, the resulting Fontan physiology is associated with high morbidity. In this review, we discuss the state of the art of the Fontan strategy by assessing survival and risk factors for mortality. Complications of the Fontan circulation, such as cardiac arrhythmia, thromboembolism, and protein-losing enteropathy, are discussed. Common surgical and catheter-based interventions following Fontan completion are outlined. We describe functional status measurements such as quality of life and developmental outcomes in the contemporary Fontan patient. The current role of drug therapy in the Fontan patient is explored. Furthermore, we assess the current use and outcomes of mechanical circulatory support in the Fontan circulation and novel surgical innovations. Despite large improvements in outcomes for contemporary Fontan patients, a large burden of disease exists in this patient population. Continued efforts to improve outcomes are warranted. Several remaining challenges in the Fontan field are outlined.

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Comparison of extracardiac conduit and lateral tunnel for functional single-ventricle patients: A meta-analysis

Abstract: EC had a lower incidence of supraventricular arrhythmia (30 days after operation) and the rate of protein losing enteropathy than LT, and requiring no cardiopulmonary bypass. These show that EC has an advantage over the LT in patients with a functional single ventricle.

Cited by 10 publications

References 54 publications

Chronotropic incompetence causes multiple organ complications in adults after the Fontan procedure

Chronotropic incompetence causes multiple organ complications in adults after the Fontan procedure

Fontan Completion in Adult Patients with Functionally Univentricular Hearts

State of the art of the Fontan strategy for treatment of univentricular heart disease

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