Original Article
Surgical management of early Fontan failure: Fontan takedown
Wei Dong, Xu Liu, Renjie Hu, Haibo Zhang, Zhiwei Xu, Jinfen Liu, Hongbin Zhu
Published 2019-02-25
Cite as Chin J Thorac Cardiovasc Surg, 2019, 35(2): 65-67. DOI: 10.3760/cma.j.issn.1001-4497.2019.02.001
Abstract
ObjectiveTo analyze the outcomes of early Fontan failure after Fontan takedown.
MethodsA retrospective study of early Fontan Failure(EFF) children undergoing Fontan takedown from November 2013 to December 2017 was performed. Fontan takedown was defined as takedown back to an intermediate circulation, superior cavopulmonary connection. Fontan takedown was performed in 14 patients. There were 9 boys and 5 girls. Children were on average aged(4.3±1.4) years when they had Fontan procedure. The mean weight was(14.3±2.7)kg. Operative procedure was extra-cardiac Fontan in 5 children, 9 had intra-cardiac Fontan. Fenestration was used in 11/14 patients. The outcomes were summarized with statistics, and risk factors for mortality after Fontan takedown were identified.
ResultsThe mortality after Fontan takedown was 4/14(28.6%). In two patients(14.3%), ECMO was followed after takedown, one of them died after two days. The time of ICU stay and hospital stay was relatively long(17.0±11.2)days and(33.8±19.4)days.The interval time between the Fontan procedure and the takedown operation is the risk fact after Fontan takedown.
ConclusionFontan takedown can be used as an effective management for the early Fontan failure, still with a high risk of mortality. Early diagnosis and takedown is recommended for EFF.
Key words:
Heart diseases congenital; Total cavopulmonary connection; Acute heart failure
Contributor Information
Wei Dong
Department of Pediatric Thoracic and Cadiovascular Surgery, Shanghai Children’s Medical Center, Medical School of Shanghai Jiaotong University, Shanghai 200127, China
Xu Liu
Department of Pediatric Thoracic and Cadiovascular Surgery, Shanghai Children’s Medical Center, Medical School of Shanghai Jiaotong University, Shanghai 200127, China
Renjie Hu
Department of Pediatric Thoracic and Cadiovascular Surgery, Shanghai Children’s Medical Center, Medical School of Shanghai Jiaotong University, Shanghai 200127, China
Haibo Zhang
Department of Pediatric Thoracic and Cadiovascular Surgery, Shanghai Children’s Medical Center, Medical School of Shanghai Jiaotong University, Shanghai 200127, China
Zhiwei Xu
Department of Pediatric Thoracic and Cadiovascular Surgery, Shanghai Children’s Medical Center, Medical School of Shanghai Jiaotong University, Shanghai 200127, China
Jinfen Liu
Department of Pediatric Thoracic and Cadiovascular Surgery, Shanghai Children’s Medical Center, Medical School of Shanghai Jiaotong University, Shanghai 200127, China
Hongbin Zhu
Department of Pediatric Thoracic and Cadiovascular Surgery, Shanghai Children’s Medical Center, Medical School of Shanghai Jiaotong University, Shanghai 200127, China
