Background and Objectives: This study aimed to analyze the outcomes of Fontan surgery in the Republic of Korea, as there were only a few studies from Asian countries. Methods: The medical records of 1,732 patients who underwent Fontan surgery in 10 cardiac centers were reviewed. Results: Among them, 1,040 (58.8%) were men. The mean age at Fontan surgery was 4.3±4.2 years, and 395 (22.8%) patients presented with heterotaxy syndrome. According to the types of Fontan surgery, 157 patients underwent atriopulmonary (AP) type; 303, lateral tunnel (LT) type; and 1,266, extracardiac conduit (ECC) type. The overall survival rates were 91.7%, 87.1%, and 74.4% at 10, 20, and 30 years, respectively. The risk factors of early mortality were male, heterotaxy syndrome, AP-type Fontan surgery, high mean pulmonary artery pressure (mPAP) in pre-Fontan cardiac catheterization, and early Fontan surgery year. The risk factors of late mortality were heterotaxy syndrome, genetic disorder, significant atrioventricular valve regurgitation (AVVR) before Fontan surgery, high mPAP in pre-Fontan cardiac catheterization, and no fenestration. Conclusions In Asian population with a high incidence of heterotaxy syndrome, the heterotaxy syndrome was identified as the poor prognostic factors for Fontan surgery. The preoperative low mPAP and less AVVR are associated with better early and long-term outcomes of Fontan surgery.

Background and Objectives: This study aimed to analyze the outcomes of Fontan surgery in the Republic of Korea, as there were only a few studies from Asian countries. Methods: The medical records of 1,732 patients who underwent Fontan surgery in 10 cardiac centers were reviewed. Results: Among them, 1,040 (58.8%) were men. The mean age at Fontan surgery was 4.3±4.2 years, and 395 (22.8%) patients presented with heterotaxy syndrome. According to the types of Fontan surgery, 157 patients underwent atriopulmonary (AP) type; 303, lateral tunnel (LT) type; and 1,266, extracardiac conduit (ECC) type. The overall survival rates were 91.7%, 87.1%, and 74.4% at 10, 20, and 30 years, respectively. The risk factors of early mortality were male, heterotaxy syndrome, AP-type Fontan surgery, high mean pulmonary artery pressure (mPAP) in pre-Fontan cardiac catheterization, and early Fontan surgery year. The risk factors of late mortality were heterotaxy syndrome, genetic disorder, significant atrioventricular valve regurgitation (AVVR) before Fontan surgery, high mPAP in pre-Fontan cardiac catheterization, and no fenestration. Conclusions In Asian population with a high incidence of heterotaxy syndrome, the heterotaxy syndrome was identified as the poor prognostic factors for Fontan surgery. The preoperative low mPAP and less AVVR are associated with better early and long-term outcomes of Fontan surgery.

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare primary headache disorder characterized by severe intractable stabbing headache and accompanying tearing and conjunctival injections. In this report, we present a case of a patient with SUNCT who achieved sustained remarkable improvement more than 6 months following successful treatment with a single session of botulinum toxin A, after being refractory or intolerant to several preventives for 4 months.

Tibiotalocalcaneal (TTC) arthrodesis is a limb salvage procedure for severe hindfoot disease and ankle deformity. Previous studies have reported several procedures, but controversy remains regarding its standard procedure. Talar body osteonecrosis can be a devastating condition that is difficult to manage surgically. Advanced-stage disease with extensive talus involvement may require a TTC arthrodesis, and the procedure frequently requires a structural bulk bone graft. A femoral head allograft and intramedullary nailing have been used to solve these problems, but a high rate of non-union was reported. The use of a talus allograft for TTC arthrodesis has been reported to achieve a higher union rate and lower complication rate. In the present case report, a patient with severe talar osteonecrosis was treated successfully with TTC arthrodesis using a talar allograft. To the best of the authors’ knowledge, this is the first report in South Korea regarding the treatment of talar osteonecrosis using TTC arthrodesis with a talar allograft.

Tibiotalocalcaneal (TTC) arthrodesis is a limb salvage procedure for severe hindfoot disease and ankle deformity. Previous studies have reported several procedures, but controversy remains regarding its standard procedure. Talar body osteonecrosis can be a devastating condition that is difficult to manage surgically. Advanced-stage disease with extensive talus involvement may require a TTC arthrodesis, and the procedure frequently requires a structural bulk bone graft. A femoral head allograft and intramedullary nailing have been used to solve these problems, but a high rate of non-union was reported. The use of a talus allograft for TTC arthrodesis has been reported to achieve a higher union rate and lower complication rate. In the present case report, a patient with severe talar osteonecrosis was treated successfully with TTC arthrodesis using a talar allograft. To the best of the authors’ knowledge, this is the first report in South Korea regarding the treatment of talar osteonecrosis using TTC arthrodesis with a talar allograft.

Tibiotalocalcaneal (TTC) arthrodesis is a limb salvage procedure for severe hindfoot disease and ankle deformity. Previous studies have reported several procedures, but controversy remains regarding its standard procedure. Talar body osteonecrosis can be a devastating condition that is difficult to manage surgically. Advanced-stage disease with extensive talus involvement may require a TTC arthrodesis, and the procedure frequently requires a structural bulk bone graft. A femoral head allograft and intramedullary nailing have been used to solve these problems, but a high rate of non-union was reported. The use of a talus allograft for TTC arthrodesis has been reported to achieve a higher union rate and lower complication rate. In the present case report, a patient with severe talar osteonecrosis was treated successfully with TTC arthrodesis using a talar allograft. To the best of the authors’ knowledge, this is the first report in South Korea regarding the treatment of talar osteonecrosis using TTC arthrodesis with a talar allograft.