The Fontan Procedure Contemporary Techniques Have Improved Long-Term Outcomes

摘要: Background— To determine whether patients undergoing the lateral tunnel and extracardiac conduit modifications of Fontan procedure have better outcomes than a classical atriopulmonary connection. Methods Results— Between 1980 2000, 305 consecutive underwent at our institution. There were 10 hospital deaths (mortality: 3%) with no death after 1990. Independent risk factors for mortality preoperative elevated pulmonary artery pressures ( P =0.002) common atrioventricular valve =0.04). was taken down during stay in 7 patients. A mean 12±6 years follow-up obtained 257 nonforeign survivors. Completeness concurrent 96%. Twenty-year survival 84% (95% CI: 79 to 89%). Recent techniques improved late survival. The 15-year connection 81% 73% 87%) versus 94% 79% 98%) =0.004). Nine pts required heart transplantation (8 connection, 1 tunnel). Undergoing modification independently predicted decreased occurrence arrhythmia, freedom from SVT 61% 51% 70%) 87% 76% 93%) =0.02). Freedom failure (death, take-down, transplantation, or NYHA class III-IV) 70% 58% 79%) 20 years. After extra-cardiac conduits, death, SVT, observed. Conclusions— remains palliation, but improved. Better patient selection minimizes mortality. Patients experience less arrhythmia are likely their circulation postponed.