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Regional Anesthesia Management in a Fontan Patient Presenting for Ambulatory Shoulder Surgery: A Case Report.
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 PDFLower Child Opportunity Index is Associated with Lower Exercise Capacity Post-Fontan Palliation.
Pediatr 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 PDFDeriving fontan-specific normative exercise data from well-functioning adolescents.
Int J Cardiol Congenit Heart Dis
September 2024
The University of Sydney, Sydney, New South Wales 2006, Australia.
Background: Exercise capacity is reduced in patients with a Fontan circulation compared to their healthy peers secondary to altered haemodynamics of the Fontan circulation. Cardiopulmonary exercise testing is routinely used in Fontan patients to assess their cardiopulmonary response to exercise and help guide management decisions, however their results are routinely compared to normative data derived from healthy individuals.
Method: Using data available from the Pediatric Heart Network, we performed a retrospective study to derive Fontan-specific normative values in a subgroup of well-functioning adolescent patients.
Evaluation of the effects of fenestration in Fontan circulation using a lumped parameter model.
J Physiol Sci
December 2024
Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Fenestration has been reported to enhance Fontan hemodynamics in several cases of Fontan circulation. However, the indication criteria for fenestration remain under discussion. To assess the effectiveness of fenestration in Fontan circulation, we conducted a theoretical analysis using a computational model of the fenestrated Fontan circulation.
View Article and Find Full Text PDFAlbuminuria Prevalence in Fontan Patients: A Systematic Review and Meta-Analysis.
Pediatr Cardiol
December 2024
Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
Patients with a Fontan circulation are at risk for chronic kidney disease (CKD), which is defined as persistently reduced glomerular filtration rate (GFR) <60ml/min/1.73 or elevated marker of kidney injury such as urinary albumin-to-creatinine ratio (UACR) >30mg/g. We determined the prevalence of albuminuria in patients with a Fontan circulation.
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