Surgical options after Fontan failure
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064203%3A_____%2F16%3A10324749" target="_blank" >RIV/00064203:_____/16:10324749 - isvavai.cz</a>
Result on the web
<a href="http://dx.doi.org/10.1136/heartjnl-2015-309235" target="_blank" >http://dx.doi.org/10.1136/heartjnl-2015-309235</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1136/heartjnl-2015-309235" target="_blank" >10.1136/heartjnl-2015-309235</a>
Alternative languages
Result language
angličtina
Original language name
Surgical options after Fontan failure
Original language description
Objective The objective of this European multicenter study was to report surgical outcomes of Fontan takedown, Fontan conversion and heart transplantation (HTX) for failing Fontan patients in terms of all-cause mortality and (re-) HTX. Methods A retrospective international study was conducted by the European Congenital Heart Surgeons Association among 22 member centres. Outcome of surgery to address failing Fontan was collected in 225 patients among which were patients with Fontan takedown (n=38; 17%), Fontan conversion (n=137; 61%) or HTX (n=50; 22%). Results The most prevalent indication for failing Fontan surgery was arrhythmia (43.6%), but indications differed across the surgical groups (p<0.001). Fontan takedown was mostly performed in the early postoperative phase after Fontan completion, while Fontan conversion and HTX were mainly treatment options for late failure. Early (30 days) mortality was high for Fontan takedown (ie, 26%). Median follow-up was 5.9 years (range 0-23.7 years). The combined end point mortality/HTX was reached in 44.7% of the Fontan takedown patients, in 26.3% of the Fontan conversion patients and in 34.0% of the HTX patients, respectively (log rank p=0.08). Survival analysis showed no difference between Fontan conversion and HTX (p=0.13), but their ventricular function differed significantly. In patients who underwent Fontan conversion or HTX ventricular systolic dysfunction appeared to be the strongest predictor of mortality or (re-) HTX. Patients with valveless atriopulmonary connection (APC) take more advantage of Fontan conversion than patients with a valvecontaining APC (p=0.04). Conclusions Takedown surgery for failing Fontan is mostly performed in the early postoperative phase, with a high risk of mortality. There is no difference in survival after Fontan conversion or HTX.
Czech name
—
Czech description
—
Classification
Type
J<sub>x</sub> - Unclassified - Peer-reviewed scientific article (Jimp, Jsc and Jost)
CEP classification
FA - Cardiovascular diseases including cardio-surgery
OECD FORD branch
—
Result continuities
Project
—
Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2016
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Heart
ISSN
1355-6037
e-ISSN
—
Volume of the periodical
102
Issue of the periodical within the volume
14
Country of publishing house
GB - UNITED KINGDOM
Number of pages
7
Pages from-to
1127-1133
UT code for WoS article
000378716600013
EID of the result in the Scopus database
2-s2.0-84964654797