Abstract
Objective To evaluate the therapeutic effect of extracardiac conduit Fontan proce-dure for the patients with complex and cyanosed congenital heart diseases. Methods From Jan 1998 to Oct 2008, 48 patients underwent extracardiac conduit Fontan procedure (37 boys and 11 girls), aging from 3.1 years to 14. 5 years (mean 5.6±3.0 years). The weight ranged from 13 kg to 56 kg (mean 21.1±10.3 kg). Twenty-three patients were diagnosed as tricuspid atresia, 20 single ventricle, 2 double outlet right ventricle (DORV), 2 pulmonary artery atresia with complete intraventricular sep-turn (PA/IVS) and 1 tetralogy of Fallot with complete atrioventricular septal defect. Preoperative SpO2 ranged from 70% to 93% (mean 80.2%±6.1%). Before the extracardiac conduit Fontan pro-cedure, 38 patients underwent two or more operations including BT. shunt (5 cases), pulmonary artery banding (4 cases) and bidirectional cavopulmonary connection (36 cases). Twelve cases underwent completed total cavopulmonary connection in the same operation. Results Three patients died at early postoperative stage and 2 died at late stage. All postoperative complications were cured, including chy-lothorax in 7 cases, pneumatothorax in 2, intrathoracic staphylococcus aureus infection in 1 and tem-poral junction tachycardia in 1. Postoperative pleural drainage was performed on all patients. All pa-tients were followed up from one month to twelve years. Thirty-five patients were evaluated as NYHA class Ⅰ , 6 NYHA classⅡ, 2 NYHA class Ⅲ. ECG showed all patients got sinus rhythm at follow-up. No significant difference was noted in mortality, duration of mechanical support, ICU stay or pleural drainage between one stage Fontan and staged Fontan procedures. Conclusions The incidence of ar-rhythmia is low in patients undergoing extracardiac conduit Fontan procedure. Fenestration is necessa-ry for patients' recovery. One stage Fontan procedure is feasible for a certain group of patients. Key words: Fontan procedure; Follow-up studies
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