Mechanical support of patients with superior cavopulmonary connection is challenging; multiple factors contribute to failure: elevated pulmonary vascular resistance, aortopulmonary collateral flow, venovenous collaterals, ventricular dysfunction, and atrioventricular valve regurgitation. We report 2 cases of conversion from a single ventricle circulation to biventricular mechanical support by reestablishing caval continuity. Both patients have demonstrated recovery of end-organ function and participation in rehabilitation. This method of support results in improved systemic venous pressures and pulmonary blood flow compared with systemic mechanical circulatory support with a cavopulmonary connection and transfers some of the complexity of the transplant to the ventricular assist device implant.
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http://dx.doi.org/10.1016/j.athoracsur.2020.12.042 | DOI Listing |
Diagnostics (Basel)
November 2024
Department of Pediatric Cardiac Surgery and Congenital Heart Disease, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico.
Background: Fontan circulation maintains an elevated venous pressure; this promotes venous and lymphatic congestion and may lead to late circuit failure. Our objective was to determine the association between thoracic lymphatic perfusion patterns assessed by magnetic resonance imaging and late Fontan failure.
Methodology: A retrospective study was performed.
Eur J Cardiothorac Surg
November 2024
Adult Congenital Heart Diseases Unit, Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas's NHS Foundation Trust, London, UK.
Objectives: There is dearth of data on long-term outcomes of systemic semilunar (SS) or atrioventricular (AV) valve operation in adult patients with a Fontan circulation. We describe a single-centre experience of adults who underwent valve surgery late after a Fontan procedure.
Methods: We retrospectively reviewed all patients with a Fontan circulation who had a reoperation for severe valve disease during adulthood in our centre.
Sci Rep
November 2024
Department of Pediatric Cardiology, University Children's Hospital, University of Tübingen, Tübingen, Germany.
Recent research in patients with functionally univentricular hearts (UVH) is focusing on pathologies of the lymphatic vessels. Morphology of the abdominal lymphatic vessels was analyzed by MRI in patients with UVH following total cavopulmonary connection (TCPC) and it was examined, if clinical and laboratory parameters correlate with changes after TCPC. We prospectively examined 33 patients at the age of 19.
View Article and Find Full Text PDFJ Am Heart Assoc
December 2024
Montreal Heart Institute, Université de Montréal Quebec Canada.
Interdiscip Cardiovasc Thorac Surg
November 2024
Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium.
Objectives: This study aims to identify the causes of failure in Fontan patients with a total cavopulmonary connection.
Methods: We conducted a comprehensive review of all patients who underwent a total cavopulmonary connection procedure at our centre between 1988 and 2023, aiming to identify and analyse the factors contributing to Fontan failure (defined as mortality, heart transplantation, Fontan takedown, protein-losing enteropathy, plastic bronchitis or New York Heart Association Functional Classification class III or IV).
Results: The study included 217 patients (median age at time of Fontan completion 3.
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