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https://www.readbyqxmd.com/read/28341356/mortality-risk-stratification-in-fontan-patients-who-underwent-heart-transplantation
#1
Christopher J Berg, Brenton S Bauer, Abbie Hageman, Jamil A Aboulhosn, Leigh C Reardon
The number of patients who require orthotopic heart transplantation (OHT) for failing Fontan physiology continues to grow; however, the methods and tools to evaluate risk of OHT are limited. This study aimed to identify a set of preoperative variables and characteristics that were associated with a greater risk of postoperative mortality in patients who received OHT for failing Fontan physiology. Thirty-six Fontan patients were identified as having undergone OHT at University of California-Los Angeles Medical Center from 1991 to 2014...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28284501/cardiopulmonary-exercise-test-in-adults-with-prior-fontan-operation-the-prognostic-value-of-serial-testing
#2
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/28271152/arrhythmias-after-fontan-operation-with-intra-atrial-lateral-tunnel-versus-extra-cardiac-conduit-a-systematic-review-and-meta-analysis
#3
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
#4
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/28242080/can-fontan-conversion-for-patients-without-late-fontan-complications-be-justified
#5
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
https://www.readbyqxmd.com/read/28237969/stenting-the-fontan-pathway-in-paediatric-patients-with-obstructed-extracardiac-conduits
#6
Floris E A Udink Ten Cate, Uwe Trieschmann, Ingo Germund, Tobias Hannes, Mathias Emmel, Gerardus Bennink, Narayanswami Sreeram
OBJECTIVES: An unobstructed extracardiac conduit (ECC) is essential for optimal Fontan haemodynamics. We aimed to evaluate the feasibility and results of percutaneous transcatheter stenting of the ECC in paediatric patients with a significant Fontan pathway obstruction. METHODS: Our institutional database was searched to identify all Fontan patients who had a stent placed in their ECC. Medical records, cardiac catheterisation data and echocardiographic investigations were reviewed...
February 25, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28219544/the-society-of-thoracic-surgeons-congenital-heart-surgery-database-2017-update-on-outcomes-and-quality
#7
Jeffrey P Jacobs, John E Mayer, Constantine Mavroudis, Sean M O'Brien, Erle H Austin, Sara K Pasquali, Kevin D Hill, David M Overman, James D St Louis, Tara Karamlou, Christian Pizarro, Jennifer C Hirsch-Romano, Donna McDonald, Jane M Han, Susan Becker, Christo I Tchervenkov, Francois Lacour-Gayet, Carl L Backer, Charles D Fraser, James S Tweddell, Martin J Elliott, Hal Walters, Richard A Jonas, Richard L Prager, David M Shahian, Marshall L Jacobs
The Society of Thoracic Surgeons Congenital Heart Surgery Database is the largest congenital and pediatric cardiac surgical clinical data registry in the world. It is the platform for all activities of The Society of Thoracic Surgeons related to the analysis of outcomes and the improvement of quality in this subspecialty. This report summarizes current aggregate national outcomes in congenital and pediatric cardiac surgery and reviews related activities in the areas of quality measurement, performance improvement, and transparency...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28184977/lateral-atrial-tunnel-fontan-operation-predisposes-to-the-junctional-rhythm
#8
Katarzyna Januszewska, Anna Schuh, Anja Lehner, Robert Dalla-Pozza, Edward Malec
The goal of the study was to compare the early postoperative course after fenestrated lateral atrial tunnel (LT) and non-fenestrated extracardiac conduit (EC) Fontan operation (FO) in a single center where both techniques were parallelly used. Between 2004 and 2012, 56(32.7%) children underwent LT and 113(66.1%) EC FO. The mean age was 3.7 ± 2.9 years and mean weight was 14.6 ± 7.3 kg. The most common malformation was hypoplastic left heart syndrome (50.9%). The general approach was to perform LT in children after hemi-Fontan operation and EC in patients after Glenn anastomosis...
February 10, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28132780/early-mortality-and-concomitant-procedures-related-to-fontan-conversion-quantitative-analysis
#9
Margarita Brida, Helmut Baumgartner, Michael A Gatzoulis, Gerhard-Paul Diller
BACKGROUND: The Fontan palliation is associated with numerous complications during long-term. The Fontan conversion operation has been advocated as an option to avoid some of these problems by converting classical Fontan types to modern forms of the circulation. Early mortality of Fontan conversion, however, remains unclear as available reports include limited numbers of patients and the results are heterogeneous. METHODS: We reviewed all original articles from 1994 to 2016 reporting Fontan conversion operations...
January 25, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28132535/modified-total-cavopulmonary-shunt-as-a-staged-fontan-operation
#10
Hidetsugu Asai, Tsuyoshi Tachibana, Yasushige Shingu, Hiroki Kato, Satoru Wakasa, Yoshiro Matsui
The left superior vena cava became occluded in an infant with hypoplastic left heart syndrome. After a bidirectional Glenn procedure, he presented with severe oxygen desaturation and right ventricular dysfunction; the left superior vena cava drained into the inferior vena cava through collateral veins. As salvage therapy, we created a modified total cavopulmonary shunt using only autologous tissue in which the right hepatic vein and inferior vena cava drained into the pulmonary artery via a lateral tunnel in the right atrium...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28094119/-safety-of-repeat-median-sternotomy-in-the-palliative-treatment-of-patients-with-univentricular-heart
#11
Héctor Díliz-Nava, Isis Meléndez-Sagaón, Orlando Tamaríz-Cruz, Luis García-Benitez, Aric Araujo-Martínez, Alexis Palacios-Macedo
OBJECTIVE: Establish the morbidity and mortality of patients with univentricular hearts who underwent repeat median sternotomy at the Instituto Nacional de Pediatría METHOD: We retrospectively review the clinical charts of all patient who underwent repeat median sternotomy from 2001 to 2016. RESULTS: Sixty-five patients underwent 76 surgeries through repeat median sternotomy. Fifty-nine patients had a first repeat median sternotomy with a mean age of 36months (range 4-176months) and a mean weight of 12...
January 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28093805/heartware-ventricular-assist-device-implantation-in-patients-with-fontan-physiology
#12
Bartlomiej R Imielski, Robert A Niebler, Steven J Kindel, Ronald K Woods
We aim to describe the clinical course of a series of patients with hypoplastic left heart syndrome and refractory systolic heart failure supported with a HeartWare ventricular assist device (HVAD) following Fontan palliation. This is a retrospective review of three consecutive patients supported with a HVAD following Fontan palliation through February 2016. Data include patient characteristics, operative variables, postimplantation hemodynamic/device parameters, event outcomes, and duration of HVAD support...
January 2017: Artificial Organs
https://www.readbyqxmd.com/read/28064364/significance-of-right-atrial-tension-for-the-development-of-complications-in-patients-after-atriopulmonary-connection-fontan-procedure-potential-indicator-for-fontan-conversion
#13
Gaku Izumi, Hideaki Senzaki, Atsuhito Takeda, Hirokuni Yamazawa, Kohta Takei, Takuo Furukawa, Kei Inai, Tokuko Shinohara, Toshio Nakanishi
Elevated right atrial (RA) pressure and progressive RA dilation are thought to play pivotal roles in the development of late complications after atriopulmonary connection (APC) Fontan surgery. However, no clear cut-off value for RA pressure or RA volume has been determined for stratifying the risk of developing Fontan complications. We hypothesized that RA tension, which incorporates information about both RA pressure and volume, might help predict the risk of developing complications. We retrospectively studied 51 consecutive APC Fontan patients (median postoperative period 14 years)...
January 7, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28007062/rescuing-the-late-failing-fontan-focus-on-surgical-treatment-of-dysrhythmias
#14
REVIEW
Carl L Backer
Patients with a failing Fontan frequently have dysrhythmias. This review will focus on the treatment of those dysrhythmias based on the 140 patients who have had a Fontan conversion with arrhythmia surgery at Ann & Robert H. Lurie Children's Hospital of Chicago (Chicago, IL). Important technical points to be emphasized are the following:• Atrial fibrillation is extremely common in patients with a failing Fontan and strong consideration should be given to a Cox-maze III during any Fontan conversion• Sinus node dysfunction is common post-conversion and all patients should receive a dual-chamber epicardial pacemaker• Careful preoperative imaging with either computed tomographic or magnetic resonance imaging is needed to predict re-entry problems at the time of repeat sternotomy• If the patient has protein-losing enteropathy, ascites, or a right or indeterminate ventricular morphology, strong consideration should be given to heart transplantation rather than a Fontan conversion and arrhythmia surgery...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27988827/atherogenic-dyslipidemia-remission-1%C3%A2-year-after-bariatric-surgery
#15
Elisenda Climent, David Benaiges, Juan Pedro-Botet, Juana A Flores-Le Roux, Jose M Ramón, Montserrat Villatoro, Laia Fontané, Juan J Chillarón, Albert Goday
PURPOSE: Given the lack of evidence of the effect of bariatric surgery (BS) on atherogenic dyslipidemia (AD), which is a characteristic of obese subjects, this study aimed to describe the remission rate of AD 1 year after BS in severely obese patients. MATERIALS AND METHODS: A non-randomised, prospective cohort study was conducted in patients undergoing laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy with a 1-year follow-up. AD was defined as triglycerides ≥1...
December 17, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27988277/the-new-zealand-norwood-procedure-experience-22-year-cumulative-review
#16
Timothy Ht Oh, John H Artrip, Chris Graddon, Cliodhna Minogue, Luciana Marcondes, Kirsten Finucane, Thomas Gentles
BACKGROUND: Babies born with a functional single ventricle heart and systemic outflow tract obstruction may require a Norwood (NW) procedure as the first of three staged procedures to obtain a Fontan circulation. This procedure and the following treatment pathway are associated with significant mortality. Risk factors for the Norwood procedure and the subsequent pathway are not necessarily the same. To identify these factors within New Zealand, the collective experience with the Norwood procedure was examined...
December 2, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27958617/results-of-the-fontan-operation-with-no-early-mortality-in-248-consecutive-patients
#17
Edward Malec, Christoph Schmidt, Anja Lehner, Katarzyna Januszewska
BACKGROUND: Fontan operation has undergone several modifications and today is the primary way to treat a broad spectrum of congenital heart defects AIM: The purpose of this study is to present the results of treatment of children with a single ventricle operated by the same surgical team and managed according to a uniform strategy. METHODS: In the years 2007-2015, in 248 children aged 3.7 ± 2.6 years and weigh of 14.6 ± 6.1 kg with a single ventricle the Fontan surgery was performed...
December 13, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27955914/liver-health-in-adults-with-fontan-circulation-a-multicenter-cross-sectional-study
#18
Fred M Wu, Brian Kogon, Michael G Earing, Jamil A Aboulhosn, Craig S Broberg, Anitha S John, Amy Harmon, Nisha I Sainani, Andrew J Hill, Robert D Odze, Melanie E Johncilla, Chinweike Ukomadu, Kimberlee Gauvreau, Anne Marie Valente, Michael J Landzberg
OBJECTIVES: Liver disease is an important contributor to morbidity and mortality in patients after Fontan surgery. There has been no large-scale survey of liver health in this population. We sought to explore the prevalence and predictors of liver disease in a multicenter cohort of adults with Fontan physiology. METHODS: Subjects were recruited from 6 adult congenital heart centers. Demographics; clinical history; and laboratory, imaging, and histopathology data were obtained...
November 12, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27898601/fontan-fenestration-closure-prior-to-posterior-spinal-fusion-in-patients-with-single-ventricle-heart-disease
#19
Matthew C Schwartz, David Nykanen, Craig Fleishman, Hamish M Munro, Jonathan Phillips, Raymond D Knapp, Donald Felix
STUDY DESIGN: Case series. OBJECTIVE: To describe transcatheter closure of the Fontan fenestration prior to posterior spinal fusion in two children to prevent paradoxical venous air embolism during the operation. SUMMARY OF BACKGROUND DATA: Scoliosis is common among patients with single-ventricle congenital heart disease who have undergone Fontan operation and spinal surgery can offer physiologic benefits. Venous air embolism is a rare, but important reported complication during spinal surgery performed in the prone position...
December 1, 2016: Spine
https://www.readbyqxmd.com/read/27888756/isolated-heart-transplant-and-combined-heart-liver-transplant-in-adult-congenital-heart-disease-patients-insights-from-the-united-network-of-organ-sharing
#20
Elisa A Bradley, Krong-On Pinyoluksana, Melissa Moore-Clingenpeel, Yongjie Miao, Curt Daniels
BACKGROUND/METHODS: The aging patient with severe congenital heart disease (CHD) faces many challenges: heart failure, arrhythmia, and in the Fontan patient, liver disease. Our goal was to define combined heart liver transplant (CHLT) and isolated orthotopic heart transplant (OHT) outcomes in U.S. adult CHD patients. The U.S. United Network for Organ Sharing (UNOS) thoracic and liver databases were queried for cardiac and CHD diagnoses, from inception-2014. RESULTS: In CHLT, CHD made up 22% of waitlist patients (non-CHD n=262 vs...
February 1, 2017: International Journal of Cardiology
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