Route selection for modified fontan in patients with functional single ventricle and apicocaval juxtaposition
10.3760/cma.j.issn.1001-4497.2017.09.008
- VernacularTitle:改良Fontan术治疗单心室合并心尖-腔静脉并置的管道路径选择
- Author:
Weidan CHEN
1
;
Li MA
;
Yuansheng XIA
;
Shengchun YANG
;
Minghui ZOU
;
Yanqin CUI
;
Mingjie ZHANG
;
Xinxin CHEN
Author Information
1. 510623,广州医科大学附属广州市妇女儿童医疗中心心脏中心
- Keywords:
Single ventricle;
Heterotaxy;
Apicocaval juxtaposition
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2017;33(9):542-545
- CountryChina
- Language:Chinese
-
Abstract:
Objective We reviewed our experience with modified Fontan in patients with functional single ventricle and apicocaval juxtaposition with a special focus on route selection and outcomes.Methods From January 201 1 to April 2016,31 patients with functional single ventricle and apicocaval juxtaposition underwent modified Fontan procedure at our hospital.Mean age at operation was(58.5 ± 32.4) months(ranged 16 months to 14 year),and the mean body weight was (16.2 ± 6.0) kg (range,9.1-40.3 kg).There were right atrial isomerism 7 cases,complete atrioventricular canal defect 9 cases,≥moderate atrioventricular valve regurgitation 4 cases,total anomalous pulmonary venous connection 8 cases,and anomalous hepatic venous connection 4 cases.Fontan procedure was performed in 5 patients,bidirectional Glenn in 13,Kawashima in 3,central shunt in 1,atrioventricular valve replacement in 5,and pulmonary artery banding in 5.Results In 24 patients,the extracardiac conduit was placed between the inferior vena cava(IVC) and the ipsilateral pulmonary artery behind the ventricle.In the 5 other patients,the conduit was placed between the IVC and the contralateral pulmonary artery.In another 2 patients the tube graft was anastomosed with the contralateral pulmonary artery(intraextracardiac Fontan).After operation,the peripheral blood oxygen saturation was 0.90 ±0.06.Five patients suffered pleural effusion,and 1 patient died of infection during hospitalization.The follow-up duration was(17.5 ± 15.4) months(1-65 months).There was no late death and reoperation.Conclusion Modified Fontan procedure in functional single ventricle and apicocaval juxtaposition can be carried out with favorable midterm outcomes.Care must be taken in regard to critical conduit oppression by the ventricle or compression on pulmonary veins.
