Long-Term Results of Fontan Procedure for Tricuspid Atresia

Abstract

To assess long-term results of the Fontan procedure for tricuspid atresia (TA), 24 survivors of 28 patients (pts) consecutively operated on between January 1972 and June 1981 were restudied noninvasively, as well as invasively. Eighteen of the pts had ventriculoarterial concordance (VAC) and six had ventriculoarterial discordance (VAD). In 14 of the 18 pts with VAC, a nonvalved woven dacron conduit had been inserted between the right atrium (RA) and the hypoplastic right ventricle (RV). From 1979 on, we preferred to use an aortic homograft to connect the RA with the RV (3 pts) [1, 2]. In the remaining case with VAC, the RV was small, malformed, and covered with coronary artery fistulae and, therefore, could not be used. In this patient, in whom pulmonary atresia was also present, an aortic homograft was used to connect the RA with the pulmonary artery (PA) directly. In all six pts with VAD, a similar technique was performed, connecting the RA with the PA directly via an aortic homograft. Follow-up time varied from 3.210.3 years (mean, 6 years).