Outcome of early and late onset Fontan operation in patients with univentricular heart repair

Abstract

To evaluate our experience in the Fontan procedure comparing those below and above 6 years of age. A review of our clinical database was conducted to identify the patients who received extracardiac Fontan between 2002 and 2010. All demographic, echocardiographic, surgical, haemodynamic and follow-up data were collected. The overall mortality was defined as death occurring from the time of surgery to the most recent follow-up. Early postoperative death was defined as death occurring during admission or within 30 days from the operation. Seventy-six patients with functionally univentricular hearts were included in the study. Patients were divided into two groups. Group A included patients who had received extracardiac Fontan at the age of 6 years or less, whereas group B included patients who had received extracardiac Fontan at an age of more than 6 years. The overall hospital mortality was 7.9% (10.2% in group A and 5.9% in group B). No statistically significant difference was seen between the two groups regarding the postoperative mortality including thrombosis, stroke, chylothorax, bleeding, pericardial effusion, wound infection, serious postoperative arrhythmias and protein losing enteropathy. On the other hand the mechanical ventilation duration, duration of hospital and ICU stay, duration of the chest tubes and the postoperative saturation was not significant between the two groups. The age of the patient at the time of Fontan surgery does not affect the results, in terms of both morbidity and mortality.