Lifetime Cardiac Reinterventions Following the Fontan Procedure

Charlotte S. Van Dorn*, Shaji C. Menon, Joyce T. Johnson, Ronald W. Day, James L. Hoffman, Anji T. Yetman

*Corresponding author for this work

Research output: Contribution to journalArticle

9 Scopus citations

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 languageEnglish (US)
Pages (from-to)329-334
Number of pages6
JournalPediatric cardiology
Volume36
Issue number2
DOIs
StatePublished - Jan 1 2015

Keywords

  • Congenital heart disease
  • Counseling
  • Fontan
  • Reintervention
  • Reoperation
  • Single ventricle palliation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Van Dorn, C. S., Menon, S. C., Johnson, J. T., Day, R. W., Hoffman, J. L., & Yetman, A. T. (2015). Lifetime Cardiac Reinterventions Following the Fontan Procedure. Pediatric cardiology, 36(2), 329-334. https://doi.org/10.1007/s00246-014-1007-2