Abstract
Patients with single ventricle physiology face significant morbidity and mortality following the Fontan procedure resulting in the need for additional cardiac reinterventions. Online patient education resources provide limited information on the reinterventions performed in single ventricle patients following the Fontan procedure. We sought to determine cardiac surgical and percutaneous reintervention rates and factors affecting reinterventions following the Fontan procedure. Databases from a single tertiary care center were retrospectively reviewed for all patients who underwent a Fontan procedure between 1978 and 2002. The number and type of cardiac surgical and percutaneous interventions following the Fontan procedure were determined, and relationships between need for reintervention and clinical variables were sought. A total of 91 patients (55 males) underwent the Fontan procedure at a median age of 5.50 years (IQR: 3.33–9.50 years). Median age at last follow-up, death, or transplant was 21.89 years (IQR: 10.87–25.51 years). Following the Fontan procedure, 60 (66 %) patients required an additional 144 median sternotomies and 61 (67 %) required 139 percutaneous cardiac interventions. Pacemaker system placement/replacement was the most common intervention following the Fontan procedure. The median time to first cardiac surgery following the Fontan was 1.96 years (IQR: 0.06–8.42 years) while the median time to the first percutaneous intervention was 7.63 years (IQR: 0.65–15.89 years). Families of single ventricle patients should be counseled on the likelihood of requiring additional cardiac interventions following the Fontan procedure.
Original language | English (US) |
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Pages (from-to) | 329-334 |
Number of pages | 6 |
Journal | Pediatric cardiology |
Volume | 36 |
Issue number | 2 |
DOIs | |
State | Published - Feb 2015 |
Funding
To assess sources of medical information available to families online, the American Medical Association Fellowship and Residency Electronic Interactive Database Access (AMA-FREIDA) was used to identify ACGME-accredited pediatric cardiology fellowship programs and their associated institution supported websites []. Each individual website was then assessed for patient education information on hypoplastic left heart syndrome or other single ventricle heart defects. The patient education provided was divided into three groups: (1) no data on number of interventions or surgical procedures, (2) 3 palliative surgeries only, and (3) additional interventions or surgical procedures following surgical palliation may be needed. This investigation was supported by the University of Utah Study Design and Biostatistics Center, which is funded in part by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant 8UL1TR000105 (formerly UL1RR025764).
Keywords
- Congenital heart disease
- Counseling
- Fontan
- Reintervention
- Reoperation
- Single ventricle palliation
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Pediatrics, Perinatology, and Child Health