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https://www.readbyqxmd.com/read/28453807/attrition-in-patients-with-single-ventricle-and-trisomy-21-outcomes-after-a-total-cavopulmonary-connection
#1
Anastasios C Polimenakos, Sujata Subramanian, Chawki ElZein, Michel N Ilbawi
OBJECTIVES: Data are limited regarding the management of children with trisomy 21 (T21) syndrome and a functional single ventricle (FSV). We evaluated patients with T21 and a FSV who had a total cavopulmonary connection (TCPC). METHODS: From September 1999 to August 2012, 139 patients with a FSV underwent a TCPC. Sixty-five had unbalanced atrioventricular septal defect. Thirteen had T21. Three (of 13) had heterotaxy syndrome. The mean age at the Fontan operation was 27...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28446492/hepatic-fibrosis-is-universal-following-fontan-operation-and-severity-is-associated-with-time-from-surgery-a-liver-biopsy-and-hemodynamic-study
#2
David J Goldberg, Lea F Surrey, Andrew C Glatz, Kathryn Dodds, Michael L O'Byrne, Henry C Lin, Mark Fogel, Jonathan J Rome, Elizabeth B Rand, Pierre Russo, Jack Rychik
BACKGROUND: Congestive hepatopathy is a recognized complication of Fontan physiology. Data regarding the incidence of hepatopathy and risk factors are lacking. METHODS AND RESULTS: Liver biopsies and cardiac catherizations were performed as part of an evaluation offered to all patients ≥10 years after Fontan. Quantitative determination of hepatic fibrosis was performed using Sirius red staining with automated calculation of collagen deposition per slide (%CD)...
April 26, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28431725/intraoperative-three-dimensional-mapping%C3%A2-of-supraventricular-tachycardia-in-a-young-fontan%C3%A2-patient
#3
James C Perry, Matthew R Williams, Suzanne Shepard, Andras Bratincsak, Cynthia Murphy, Raghav Murthy, Mohammad Ebrahim, John J Lamberti
Preoperative tachycardia is uncommon before an initial Fontan procedure. Catheter intervention can risk complications in small patients. A patient with fetal tachycardia and double inlet left ventricle underwent Norwood and bidirectional Glenn procedures. She had persistent tachycardia. A three-dimensional electroanatomic mapping system was modified for the operative procedure; it was used to identify the arrhythmia substrate and cryoablate an atrioventricular nodal tachycardia. Mapping added 20 minutes to the operation...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28422842/the-role-of-renoscintigraphy-and-surgery-in-the-management-of-page-kidney-a-case-report
#4
Yu-Li Chiu, Chin Hu, Sin-Di Lee, Po-Yin Chen, Cheng-Pin Wang
RATIONALE: Page kidney is an uncommon condition that hypertension occurs secondary to microvascular ischemia and alternation of small-vessel hemodynamics due to external compression of renal parenchyma and activation of the renin-angiotensin-aldosterone system. There are no specific guidelines for the management of Page kidney in the literatures. PATIENT CONCERNS: A 17-year-old teenager who had Fontan procedure for tricuspid and pulmonary atresia in early childhood suffered from sudden onset of severe left flank pain during cardiac catheterization procedure...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28402400/unplanned-cardiac-reoperations-and-interventions-during-long-term-follow-up-after-the-norwood-procedure%C3%A2
#5
Eva Sames-Dolzer, Gregor Gierlinger, Michaela Kreuzer, Julia Schrempf, Roland Gitter, Christoph Prandstetter, Gerald Tulzer, Rudolf Mair
OBJECTIVES: Patients with hypoplastic left heart syndrome or related malformations are predominantly treated with a 3-stage palliation. Anatomic or physiologic problems can lead to unplanned additional surgical or catheter interventions during single ventricle palliation. Changes in operative technique may have an impact on the reoperation rate. METHODS: Between 1997 and 2014, 317 Norwood procedures were performed at our centre. A retrospective single centre investigation was carried out concerning incidence, timing, indication and type of unplanned interstage cardiac reoperations and catheter interventions during follow-up of Norwood patients...
April 11, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28386502/transumbilical-surgery-for-duodenal-stenosis-in-a-child-with-situs-inversus-the-first-report
#6
Isamu Saeki, Yu Ueno, Wataru Mukai, Reisuke Imaji, Takashi Akiyama
Background. Situs inversus is a rare congenital anomaly with a reported incidence of only 1 in 5,000 to 10,000 live births. Congenital duodenal stenosis complicated with situs inversus is an even rarer entity. Case Presentation. A 1-year-old girl with situs inversus who had undergone a hemi-Fontan procedure against a single ventricle in our hospital was referred to our department for vomiting and failure to thrive. An upper gastrointestinal contrast study and endoscopy revealed duodenal stenosis. A transumbilical radical operation as a minimally invasive surgery was successfully performed...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28385377/the-effects-of-modification-to-lateral-tunnel-fontan-procedure-for-prophylactic-arrhythmia-surgery
#7
Hong-Gook Lim, Jeong Ryul Lee, Yong Jin Kim
BACKGROUND: Refractory atrial arrhythmias and hemodynamic abnormalities are responsible for significant morbidity and mortality after the Fontan operation. We evaluated the long-term feasibility, safety, and efficacy of prophylactic atrial arrhythmia surgery performed concomitantly with the lateral tunnel Fontan operation. METHODS: From 1997 August to 2003 December, 27 patients underwent a initial lateral tunnel Fontan with an interventional atrial incision and cryoablation from the atriotomy to the coronary sinus and right atrioventricular valve annulus...
April 3, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28385177/effect-of-fontan-associated-morbidities-on-survival-with-intact-fontan-circulation
#8
Kiona Y Allen, Tacy E Downing, Andrew C Glatz, Lindsay S Rogers, Chitra Ravishankar, Jack Rychik, Stephanie Fuller, Lisa M Montenegro, James M Steven, Thomas L Spray, Susan C Nicolson, James William Gaynor, David J Goldberg
Although survival after the Fontan operation has improved, little is known about the burden of major medical morbidities associated with the modern total cavopulmonary connection (TCPC). A total of 773 consecutive patients who underwent a first Fontan operation at our institution between 1992 and 2009 were retrospectively reviewed. All subjects underwent TCPC (53% lateral tunnel, 47% extracardiac conduit). Median length of follow-up was 5.3 years (interquartile range 1.4 to 11.2), and 30% had follow-up >10 years...
March 16, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28376950/impact-of-the-location-of-the-fenestration-on-fontan-circulation-haemodynamics-a-three-dimensional-computational-model-study
#9
Koichi Sughimoto, Yuta Asakura, Christian P Brizard, Fuyou Liang, Takashi Fujiwara, Kagami Miyaji, Hao Liu
OBJECTIVES: There is no consensus or theoretical explanation regarding the optimal location for the fenestration during the Fontan operation. We investigated the impact of the location of the fenestration on Fontan haemodynamics using a three-dimensional Fontan model in various physiological conditions. METHODS: A three-dimensional Fontan model was constructed on the basis of CT images, and a 4-mm-diameter fenestration was located between the extracardiac Fontan conduit and the right atrium at three positions: superior, middle, and inferior part of the conduit...
April 5, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28372802/non-invasive-electrocardiographic-predictors-of-atrial-arrhythmias-in-patients-with-the-fontan-palliation
#10
Daniel Cortez, Nandita Sharma, Jason R Imundo, Mark Cohen
BACKGROUND: Fontan palliation patients are at risk for atrial arrhythmias post-operatively. This study aimed to evaluate whether differences in depolarization vector magnitude or spatial P-R angle can reliably predict atrial arrhythmias in patients who had undergone Fontan palliation. METHODS: A total of 115 patients who had Fontan palliation and post-Fontan catheterization were included. Atrial arrhythmias were identified in 14 patients. Measurements of ECG parameters including QRS vector magnitude, P-R duration, spatial QRS-T angle and spatial P-R angle were performed, and compared between those with and without atrial arrhythmias...
March 14, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28341469/long-term-survival-after-the-fontan-operation-twenty-years-of-experience-at-a-single-center
#11
Tacy E Downing, Kiona Y Allen, Andrew C Glatz, Lindsay S Rogers, Chitra Ravishankar, Jack Rychik, Jennifer A Faerber, Stephanie Fuller, Lisa M Montenegro, James M Steven, Thomas L Spray, Susan C Nicolson, J William Gaynor, David J Goldberg
OBJECTIVE: Existing studies of patients palliated with the Fontan operation are limited by heterogeneous patient populations and incomplete follow-up. This study aimed to describe long-term post-Fontan survival in a modern patient cohort. METHODS: All 773 patients who underwent a first Fontan operation at our institution between 1992 and 2009 were reviewed. The primary outcome was the composite endpoint of Fontan takedown, heart transplantation, or death before 2013...
March 6, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28314526/what-is-the-best-material-for-extracardiac-fontan-operation
#12
EDITORIAL
Toshiharu Shinoka
No abstract text is available yet for this article.
February 21, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28284501/cardiopulmonary-exercise-test-in-adults-with-prior-fontan-operation-the-prognostic-value-of-serial-testing
#13
Alexander C Egbe, David J Driscoll, Arooj R Khan, Sameh S Said, Emmanuel Akintoye, Fernando M Berganza, Heidi M Connolly
BACKGROUND: The purpose of the study was to determine the role of cardiopulmonary exercise test (CPET) indices in predicting cardiovascular adverse events (CAEs) in patients with Fontan palliation. CAE was defined as death or cardiac surgery. METHODS: Retrospective review of adult Fontan patients who had treadmill CPET at Mayo Clinic, 1994-2013. Patients with loss of follow-up defined as ≥2years without clinical follow-up were excluded. The results of serial CPETs were reviewed, and patients with CPETs meeting the following criteria were selected for analysis: maximum effort on serial CPETs, minimum of 3-year interval between CPETs, and absence of CAE between CPETs...
May 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28281411/abnormalities-in-serum-biomarkers-correlate-with-lower-cardiac-index-in-the-fontan-population
#14
MULTICENTER STUDY
Bradley S Marino, David J Goldberg, Adam L Dorfman, Eileen King, Heidi Kalkwarf, Babette S Zemel, Margaret Smith, Jesse Pratt, Mark A Fogel, Amanda J Shillingford, Barbara J Deal, Anitha S John, Caren S Goldberg, Timothy M Hoffman, Marshall L Jacobs, Asher Lisec, Susan Finan, Lazaros K Kochilas, Thomas W Pawlowski, Kathleen Campbell, Clinton Joiner, Stuart L Goldstein, Paul Stephens, Alvin J Chin
BACKGROUND: Fontan survivors have depressed cardiac index that worsens over time. Serum biomarker measurement is minimally invasive, rapid, widely available, and may be useful for serial monitoring. The purpose of this study was to identify biomarkers that correlate with lower cardiac index in Fontan patients. Methods and results This study was a multi-centre case series assessing the correlations between biomarkers and cardiac magnetic resonance-derived cardiac index in Fontan patients ⩾6 years of age with biochemical and haematopoietic biomarkers obtained ±12 months from cardiac magnetic resonance...
January 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28277152/visuospatial-processing-in-adolescents-with-critical-congenital-heart-disease-organization-integration-and-implications-for-academic-achievement
#15
Jessica L Bean Jaworski, Matthew T White, David R DeMaso, Jane W Newburger, David C Bellinger, Adam R Cassidy
Among the most significant factors affecting quality of life in individuals with critical congenital heart disease (CCHD) are neurodevelopmental challenges, including deficits in visuospatial processing and academic achievement. Few studies have compared outcomes across CCHD subgroups, despite their significant differences in anatomy/physiology and medical/surgical courses. This study compared visuospatial processing abilities using the Developmental Scoring System for the Rey-Osterrieth Complex Figure (DSS-ROCF) across groups of adolescents with CCHD (d-transposition of the great arteries [TGA, n = 139], Tetralogy of Fallot [TOF, n = 68], single-ventricle cardiac anatomy requiring the Fontan operation [SVF, n = 145]) and a group of healthy controls (CTR, n = 111), and examined the validity of visuospatial processing in predicting concurrent academic outcomes...
February 16, 2017: Child Neuropsychology: a Journal on Normal and Abnormal Development in Childhood and Adolescence
https://www.readbyqxmd.com/read/28271152/arrhythmias-after-fontan-operation-with-intra-atrial-lateral-tunnel-versus-extra-cardiac-conduit-a-systematic-review-and-meta-analysis
#16
Dongxu Li, Qiang Fan, Yasutaka Hirata, Minoru Ono, Qi An
Current studies on the incidence of arrhythmias after the intra-atrial lateral tunnel (ILT) Fontan operation and the extra-cardiac conduit (ECC) Fontan operation are limited, with controversial results. This systematic review aimed to compare the prevalence of arrhythmias in patients who underwent ECC or ILT Fontan. Relevant studies comparing the incidence of arrhythmias and pacemaker implantation in ILT with ECC were identified through a literature search using MEDLINE, EMBASE, and the cochrane central register of controlled trials...
March 7, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28262297/femoral-vein-homograft-as-right-ventricle-to-pulmonary-artery-conduit-in-stage-1-norwood-operation
#17
T K Susheel Kumar, Mario Briceno-Medina, Shyam Sathanandam, Vijaya M Joshi, Christopher J Knott-Craig
BACKGROUND: The polytetrafluoroethylene tube used as right ventricle to pulmonary artery conduit in the stage 1 Norwood operation is associated with risks of suboptimal branch pulmonary artery growth, thrombosis, free insufficiency, and long-term right ventricular dysfunction. Our experience with use of valved femoral vein homograft as right ventricle to pulmonary artery conduit is described. METHODS: Between June 2012 and December 2015, 15 neonates with hypoplastic left heart syndrome or complex single ventricle underwent stage 1 Norwood operation with valved segment of femoral vein homograft as right ventricle to pulmonary artery conduit...
March 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28257439/diminished-liver-microperfusion-in-fontan-patients-a-biexponential-dwi-study
#18
Hildebrand Dijkstra, Djoeke Wolff, Joost P van Melle, Beatrijs Bartelds, Tineke P Willems, Matthijs Oudkerk, Hans Hillege, Aad P van den Berg, Tjark Ebels, Rolf M F Berger, Paul E Sijens
It has been demonstrated that hepatic apparent diffusion coefficients (ADC) are decreasing in patients with a Fontan circulation. It remains however unclear whether this is a true decrease of molecular diffusion, or rather reflects decreased microperfusion due to decreased portal blood flow. The purpose of this study was therefore to differentiate diffusion and microperfusion using intravoxel incoherent motion (IVIM) modeled diffusion-weighted imaging (DWI) for different liver segments in patients with a Fontan circulation, compare to a control group, and relate with liver function, chronic hepatic congestion and hepatic disease...
2017: PloS One
https://www.readbyqxmd.com/read/28242224/validation-of-a-method-to-monitor-the-occurrence-of-20-relevant-pharmaceuticals-and-personal-care-products-in-167-bottled-waters
#19
Sophie Lardy-Fontan, Véronique Le Diouron, Catherine Drouin, Béatrice Lalere, Sophie Vaslin-Reimann, Xavier Dauchy, Christophe Rosin
Research on emerging substances in drinking water presents major interest and the possibility of trace contamination has seen increasing concern from the scientific community and the public authorities. More particularly, residues of pharmaceuticals and personal care products (PPCPs) in bottled water are a very important issue due to societal concerns and potential media impact. In this context, it has become necessary to carry out reliable monitoring. This requires measurements of high quality with demonstration of accuracy and well-defined uncertainty...
February 24, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28242080/can-fontan-conversion-for-patients-without-late-fontan-complications-be-justified
#20
Akihiko Higashida, Takaya Hoashi, Koji Kagisaki, Masatoshi Shimada, Hideo Ohuchi, Isao Shiraishi, Hajime Ichikawa
BACKGROUND: Fontan conversion from a classic Fontan operation such as atriopulmonary connection to total cavopulmonary connection with antiarrhythmia surgery is currently not indicated for patients without any late Fontan complications. METHODS: Thirty-two consecutive patients who underwent Fontan conversion between 1991 and 2012 were divided into 2 groups by the presence (group 1: n = 25, atrial tachyarrhythmia [AT] in 24 and protein-losing enteropathy in 4) or absence (group 2: n = 7) of late Fontan complications, and the surgical outcomes were retrospectively compared...
February 24, 2017: Annals of Thoracic Surgery
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