Background: We reviewed the preoperative hemodynamic factors, surgical results and intermediate outcome of Fontan procedure in hypoplastic left heart syndrome (HLHS).
Method: From 1990 to 2006, 34 patients with HLHS completed Fontan procedure in our hospital. We compared preoperative hemodynamic factors, surgical results and postoperative course between HLHS group and functional single right ventricle (SRV) group who had undergone Fontan procedure. In addition, influence of the initial palliation [Norwood procedure with modified Blalock-Taussig (BT) shunt, Norwood procedure with right ventricle (RV)-pulmonary artery (PA) conduit and bilateral PA banding] to surgical results and postoperative course was investigated.
Results: The PA index was smaller in HLHS group than SRV group but there was no difference in surgical results and intermediate outcome between the 2 groups. Although age at Fontan was older in Norwood with BT shunt, preoperative hemodynamic factors, surgical results and intermediate outcome were similar between the 3 groups.
Conclusion: Although the PA index in HLHS group was small, the surgical results of Fontan procedure in HLHS group were comparable with those in SRV group. The surgical result of Fontan procedure was satisfactory irrespective of the initial palliative procedure.
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Hepatol Commun
December 2024
Division of Pediatric Cardiology, Department of Pediatrics, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Background: Despite the development of several imaging modalities for diagnosing Fontan-associated liver disease (FALD), there is no optimal protocol for the follow-up of FALD. We conducted a systematic review and meta-analysis to identify factors related to liver fibrosis using biopsy reports and to identify alternative noninvasive modalities that could better reflect liver histological changes in FALD.
Methods: A systematic review and meta-analysis were conducted following the PRISMA guidelines Table S2.
A A Pract
January 2025
From the Department of Anesthesia, Indiana University School of Medicine, Indianapolis, Indiana.
Interscalene blocks, commonly used for shoulder surgery analgesia, often cause transient phrenic nerve palsy, leading to hemi-diaphragmatic paresis. This complication is particularly problematic in patients with pulmonary comorbidities and has been extensively investigated. However, its impact on patients with Fontan physiology remains less understood with limited representation in the literature.
View Article and Find Full Text PDFPediatr Cardiol
December 2024
Division of Pediatric Cardiology, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, 5Th Floor Faculty Pavilion, Pittsburgh, PA, 15224, USA.
The Child Opportunity Index (COI) is a validated measurement that uses a composite index of 29 indicators of social determinants of health linked to the US Census. Patients post-Fontan palliation for single ventricle physiology often have reduced exercise capacity compared to the general population. Our hypothesis is that COI levels are directly associated with exercise capacity and inversely with late outcomes.
View Article and Find Full Text PDFInt J Cardiol Congenit Heart Dis
December 2024
Paediatric Diabetes and Endocrine Service, Starship Child Health, Te Toka Tumai Auckland Te Whatu Ora, Auckland, New Zealand.
Objective: Short stature, central hypothyroidism and infertility are common in those with a Fontan circulation. Given that the Fontan circulation often results in hepatic portal venous congestion, we hypothesize that the hypothalamic-pituitary portal circulation is also affected, contributing to subsequent hypothalamic-pituitary axis dysfunction.
Methods: MRI data from the Australian and New Zealand Fontan Registry (86 cases) was compared to 86 age- and sex-matched normal published controls.
Int J Cardiol Congenit Heart Dis
June 2024
Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Background: Extracardiac conduit Fontan procedure (ECFP) employing a Gore-Tex conduit has been widely used for patients with single ventricle physiology; however, the long-term status of the conduit is unknown. We investigated the changes in a Gore-Tex conduit after ECFP and the factors associated with its narrowing.
Methods: We conducted a retrospective analysis of 86 patients who underwent ECFP between January 1995 and December 2008 and had cardiac computed tomography (CT) during the follow-up period.
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