Long term evaluaction of cardiopulmonary function in 20 years after Fontan surgery
10.3760/cma.j.issn.1001-4497.2019.02.002
- VernacularTitle:Fontan类手术后20年远期心肺功能评价
- Author:
Chunzhen ZHANG
1
;
Huishan WANG
;
Zengwei WANG
;
Minhua FANG
;
Zongtao YIN
;
Guoxu ZHANG
;
Yan JIN
Author Information
1. 沈阳军区总医院心血管外科 110016
- Keywords:
Fontan procedure;
Heart disease;
congenital
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2019;35(2):68-71
- CountryChina
- Language:Chinese
-
Abstract:
To evaluate the long term cardiopulmonary function after Fontan operation. Methods 10 patients who received Fontan operation were followed for(26 ±4) years in our hospital. 7 males and 3 females,(30. 7 ± 13. 2) years old(20 -60 years). All patients were diagnosed by echocardiography, CTA, 24 h ECG, cardiac catheterization, pulmonary angiography, radionuclide pulmonary blood perfusion and cardiopulmonary exercise test. Results Echocardiography shows: LVEF(0. 49 ± 0. 04), more than moderate atrioventricular valve regurgitation in 7 cases. CTA shows: there was no anastomotic stenosis, arteriovenous fistula in 4 cases. 24 h ECG shows: sinus rhythm in 7 cases, frequent paroxysmal atrial tachycardia in 1 case, atrial flutter in one and atrial fibrillation in one. Cardiac catheterization and pulmonary angiography show: the average pulmonary artery pressure(17. 8 ±2. 0)mmHg, average pulmonary resistance(4. 17 ±0. 56) woods. Radionuclide pulmonary blood perfusion shows: pulmonary blood of upper lung was reduced significantly with unbalanced distribution. Cardiopulmonary exercise test shows: both of lung ventilation function and heart reserve function decreased moderately or severely. Protein losing enteropathy was found in 1 case. Conclusion The decrease of cardiopulmonary function is found after Fontan operation during the long-term follow up for 20 years, especially for cardiac function. More attention should be paid to the early postoperative atrioventricular valve regurgitation. Unbalanced distribution of pulmonary blood is Found in long term. The incidence of arrhythmia after extra conduit Fontan operation is lower than other methods.
