Separating the Circulations: Cavopulmonary Connections (Bidirectional Glenn, Hemi-Fontan) and the Modified Fontan Operation

Marino, Bradley S.; Spray, Thomas L.; Greeley, William J.

doi:10.1016/b978-032301281-2.50043-6

Cited by 2 publications

(2 citation statements)

References 120 publications

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“…This is likely due to the fact that early postoperative development of venovenous collaterals leading to prohibitive cyanosis is a result of failing stage II physiology. 1,[8][9][10] Occluding the collaterals serves only to increase the SVC pressure further, often leading to the development of additional collaterals. The formation of collateral vessels should be viewed as a surrogate marker for a deleterious physiologic state, and only improvement in the underlying physiologic condition will lead to improved patient outcomes.…”

Section: Commentmentioning

confidence: 99%

“…This serves to volume unload the ventricle while providing a more effective and controlled source of low-pressure pulmonary blood flow. [1][2][3][4] This operation also affords an opportunity to correct any anatomic or hemodynamically significant lesions that may increase the operative risk at Fontan completion. 4 In general, the stage II palliation has a relatively low early mortality rate of 3% to 4.7%, with survival to Fontan completion of 87% to 91.3%.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Early Cyanosis After Stage II Palliation for Single Ventricle Physiology

Zampi

Hirsch-Romano

Armstrong

2013

World J Pediatr Congenit Heart Surg

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Section: Commentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Early Cyanosis After Stage II Palliation for Single Ventricle Physiology

Zampi

Hirsch-Romano

Armstrong

2013

World J Pediatr Congenit Heart Surg

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Understanding Stage II Bidirectional Cavopulmonary Shunts

George-Hyslop

Thomas

Fazari

2017

Critical Care Nurse

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Despite improvements in surgical technique and medical management, single-ventricle lesions remain one of the most challenging congenital heart anomalies to treat, and mortality rates are high. Most infants who have single-ventricle palliation undergo a sequence of surgeries to optimize pulmonary and systemic blood flow. The first surgery to separate pulmonary and systemic blood flow is the bidirectional cavopulmonary shunt. This article describes single-ventricle lesions and gives a basic overview of outcomes and strategies to improve interstage mortality. Preoperative investigations that evaluate stage II candidacy are reviewed along with surgical approaches and postoperative physiology. Although mortality rates are low and decreasing in patients with bidirectional cavopulmonary shunts, morbidity is still a challenge. Nurses must understand the pertinent anatomy and physiology and recognize postoperative complications early in order to reduce morbidity. Postoperative complications, management, outcomes and nursing care are discussed.

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Separating the Circulations: Cavopulmonary Connections (Bidirectional Glenn, Hemi-Fontan) and the Modified Fontan Operation

Cited by 2 publications

References 120 publications

Early Cyanosis After Stage II Palliation for Single Ventricle Physiology

Early Cyanosis After Stage II Palliation for Single Ventricle Physiology

Understanding Stage II Bidirectional Cavopulmonary Shunts

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