HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Vladimir Alexi-Meskishvili Roland Hetzer Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ovroutski, S. Articles by Lange, P. E. Search for Related Content PubMed PubMed Citation Articles by Ovroutski, S. Articles by Lange, P. E. Related Collections Congenital - cyanotic

Eur J Cardiothorac Surg 2004;26:1073-1079
© 2004 Elsevier Science NL

Comparison of somatic development and status of conduit after extracardiac Fontan operation in young and older children

^a Department of Congenital Heart Diseases, Deutsches Herzzentrum Berlin (German Heart Institute Berlin), Augustenburger Platz 1, 13533 Berlin, Germany
^b Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin (German Heart Institute Berlin), Augustenburger Platz 1, 13533 Berlin, Germany

Received 22 February 2004; received in revised form 15 June 2004; accepted 1 July 2004.

^* Corresponding author. Tel.: +49-30-4593-2800; fax: +49-30-4593-2900. (E-mail: ovroutski{at}dhzb.de).

Objective: We set out to examine whether the extracardiac Fontan operation (ECFO) in young children is beneficial for the early postoperative course and whether it has a negative impact on the mid-term hemodynamics and growth of the children due to absent growth potential of the prosthetic conduit. Therefore we compared our medium-term experience with ECFO in children under 4 years of age to that in older children regarding the incidence of postoperative complications, somatomotoric development and conduit status. Methods and results: Between 11/95 and 12/02 ECFO was performed in 30 children under 4 years of age and 21 older children aged 4–13 years. There were no deaths in children under 4 years of age and two older children died. No prolonged support (>72h) of suprarenin was required in small children compared to 4 older children. In twenty-seven children, who underwent postoperative heart catheterization no pulmonary artery or systemic vein distortion occurred. One re-operation and one transcatheter intervention were performed because of the partial conduit stenosis. During the median follow-up of 4.8 years a manifestly accelerated postoperative weight gain was observed in children operated on under 4 years of age, compared to that in older children (up to the 50 vs. 10th percentile, P<0.05). Conclusions: The ECFO could be performed in young children with low morbidity and mortality rates. In the majority of patients, implanted prosthetic grafts maintain stable form without the development of stenosis. Accelerated somatic development, especially in small children, is to be observed after completion of the Fontan circulation.

This article has been cited by other articles:

				Y. Ochiai, Y. Imoto, M. Sakamoto, T. Kajiwara, A. Sese, M. Watanabe, T. Ohno, and K. Joo Mid-term follow-up of the status of Gore-Tex graft after extracardiac conduit Fontan procedure Eur. J. Cardiothorac. Surg., July 1, 2009; 36(1): 63 - 68. [Abstract] [Full Text] [PDF]

				S. Ovroutski, P. Ewert, V. Alexi-Meskishvili, K. Holscher, O. Miera, B. Peters, R. Hetzer, and F. Berger Absence of pulmonary artery growth after fontan operation and its possible impact on late outcome. Ann. Thorac. Surg., March 1, 2009; 87(3): 826 - 831. [Abstract] [Full Text] [PDF]

				L T Eskedal, P S Hagemo, E Seem, A Eskild, M Cvancarova, S Seiler, and E Thaulow Impaired weight gain predicts risk of late death after surgery for congenital heart defects Arch. Dis. Child., June 1, 2008; 93(6): 495 - 501. [Abstract] [Full Text] [PDF]

				K. N. Vogt, C. Manlhiot, G. Van Arsdell, J. L. Russell, S. Mital, and B. W. McCrindle Somatic Growth in Children With Single Ventricle Physiology: Impact of Physiologic State J. Am. Coll. Cardiol., November 6, 2007; 50(19): 1876 - 1883. [Abstract] [Full Text] [PDF]

				T. Nakano, H. Kado, T. Tachibana, K. Hinokiyama, A. Shiose, M. Kajimoto, and Y. Ando Excellent Midterm Outcome of Extracardiac Conduit Total Cavopulmonary Connection: Results of 126 Cases Ann. Thorac. Surg., November 1, 2007; 84(5): 1619 - 1626. [Abstract] [Full Text] [PDF]

				M. Ono, D. Boethig, H. Goerler, M. Lange, M. Westhoff-Bleck, and T. Breymann Somatic development long after the Fontan operation: factors influencing catch-up growth. J. Thorac. Cardiovasc. Surg., November 1, 2007; 134(5): 1199 - 1206. [Abstract] [Full Text] [PDF]

				C. Lee, C.-H. Lee, S. W. Hwang, H. G. Lim, S.-J. Kim, J. Y. Lee, W.-S. Shim, and W.-H. Kim Midterm follow-up of the status of Gore-Tex graft after extracardiac conduit Fontan procedure Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1008 - 1012. [Abstract] [Full Text] [PDF]