Principles of the fontan conversion operation

Constantine Mavroudis; Barbara Deal; Carl L Backer

doi:10.1007/978-1-4471-4619-3_187

Principles of the fontan conversion operation

Constantine Mavroudis^*, Barbara Deal, Carl L Backer

^*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceeding › Chapter

Abstract

The sequelae of Fontan-type repairs for functionally univentricular hearts include hemodynamic changes related to atrial enlargement and underlying anatomy, arrhythmias, and multiorgan system effects. Therapeutic interventions addressing both hemodynamic sequelae and arrhythmia substrates have been effective in improving quality of life and markedly reducing arrhythmia recurrence during midterm follow-up. Successful arrhythmia intervention requires careful assessment of the arrhythmia mechanisms and application of the appropriate surgical ablation techniques. The surgical intervention is challenging owing to redo sternotomy in univentricular physiology and anatomic variations. This chapter outlines the authors’ resternotomy and operative techniques for safe mediastinal reentry and the surgical and anatomic variants encountered in association with Fontan conversion.

Original language	English (US)
Title of host publication	Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care
Publisher	Springer Verlag London Ltd
Pages	2589-2608
Number of pages	20
ISBN (Electronic)	9781447146193
ISBN (Print)	9781447146186
DOIs	https://doi.org/10.1007/978-1-4471-4619-3_187
State	Published - Jan 1 2014

Keywords

Accessory connections
Arrhythmia
Atrial enlargement
Atrial fibrillation
Atrioventricular nodal reentry tachycardia
Extracardiac total cavopulmonary connection
Hemodynamic repair
Resternotomy
Surgical ablation techniques
Univentricular hearts

ASJC Scopus subject areas

General Medicine

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10.1007/978-1-4471-4619-3_187

Cite this

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title = "Principles of the fontan conversion operation",

abstract = "The sequelae of Fontan-type repairs for functionally univentricular hearts include hemodynamic changes related to atrial enlargement and underlying anatomy, arrhythmias, and multiorgan system effects. Therapeutic interventions addressing both hemodynamic sequelae and arrhythmia substrates have been effective in improving quality of life and markedly reducing arrhythmia recurrence during midterm follow-up. Successful arrhythmia intervention requires careful assessment of the arrhythmia mechanisms and application of the appropriate surgical ablation techniques. The surgical intervention is challenging owing to redo sternotomy in univentricular physiology and anatomic variations. This chapter outlines the authors{\textquoteright} resternotomy and operative techniques for safe mediastinal reentry and the surgical and anatomic variants encountered in association with Fontan conversion.",

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AU - Backer, Carl L

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N2 - The sequelae of Fontan-type repairs for functionally univentricular hearts include hemodynamic changes related to atrial enlargement and underlying anatomy, arrhythmias, and multiorgan system effects. Therapeutic interventions addressing both hemodynamic sequelae and arrhythmia substrates have been effective in improving quality of life and markedly reducing arrhythmia recurrence during midterm follow-up. Successful arrhythmia intervention requires careful assessment of the arrhythmia mechanisms and application of the appropriate surgical ablation techniques. The surgical intervention is challenging owing to redo sternotomy in univentricular physiology and anatomic variations. This chapter outlines the authors’ resternotomy and operative techniques for safe mediastinal reentry and the surgical and anatomic variants encountered in association with Fontan conversion.

AB - The sequelae of Fontan-type repairs for functionally univentricular hearts include hemodynamic changes related to atrial enlargement and underlying anatomy, arrhythmias, and multiorgan system effects. Therapeutic interventions addressing both hemodynamic sequelae and arrhythmia substrates have been effective in improving quality of life and markedly reducing arrhythmia recurrence during midterm follow-up. Successful arrhythmia intervention requires careful assessment of the arrhythmia mechanisms and application of the appropriate surgical ablation techniques. The surgical intervention is challenging owing to redo sternotomy in univentricular physiology and anatomic variations. This chapter outlines the authors’ resternotomy and operative techniques for safe mediastinal reentry and the surgical and anatomic variants encountered in association with Fontan conversion.

KW - Accessory connections

KW - Arrhythmia

KW - Atrial enlargement

KW - Atrial fibrillation

KW - Atrioventricular nodal reentry tachycardia

KW - Extracardiac total cavopulmonary connection

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KW - Resternotomy

KW - Surgical ablation techniques

KW - Univentricular hearts

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ER -

Principles of the fontan conversion operation

Abstract

Keywords

ASJC Scopus subject areas

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