Usefulness of external counterpulsation early postoperatively after the Fontan procedure in children

Abstract

External counterpulsation (EC) is a noninvasive circulatory assistance technique that improves coronary blood flow and myocardial performance, augments systemic venous return, and reduces ventricular afterload. 1 Lawson W.E. Hui J.C.K. Zheng Z.S. Oster Z. Katz J.P. Diggs P. Burger L. Cohn C.D. Soroff H.S. Cohn P.F. Three-year sustained benefit from enhanced external counterpulsation in chronic angina pectoris. Am J Cardiol. 1995; 75: 840-841 Abstract Full Text PDF PubMed Scopus (86) Google Scholar , 2 Taguchi I. Ogawa K. Oida A. Abe S. Kaneko N. Sakio H. Comparison of hemodynamic effects of enhanced external counterpulsation and intra-aortic balloon pumping in patients with acute myocardial infarction. Am J Cardiol. 2000; 86: 1139-1141 Abstract Full Text Full Text PDF PubMed Scopus (69) Google Scholar , 3 Urano H. Ikeda H. Ueno T. Matsumoto T. Murohara T. Imaizumi T. Enhanced external counterpulsation improves exercise tolerance, reduces exercise-induced myocardial ischemia and improves left ventricular diastolic filling in patients with coronary artery disease. J Am Coll Cardiol. 2001; 37: 93-99 Abstract Full Text Full Text PDF PubMed Scopus (141) Google Scholar We hypothesized that EC could benefit patients who underwent the Fontan procedure by improving cardiac output in the early postoperative period. EC had not been studied in the postoperative setting, and had never previously performed in the pediatric population. Therefore, this investigation sought to provide preliminary evidence of EC safety and short-term efficacy in children after Fontan surgery.