caa a22 4500 445823895 CHVBK 20180317145253.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s00246-011-9973-0 doi (NATIONALLICENCE)springer-10.1007/s00246-011-9973-0 The Fontan Operation: The Pursuit of Associated Lesions and Cumulative Trauma [Elektronische Daten] [Robert Hannan, Jennifer Zabinsky, Jane Salvaggio, Anthony Rossi, Danyal Khan, Francisco Alonso, Jorge Ojito, David Nykanen, Evan Zahn, Redmond Burke] Our programmatic approach to the Fontan operation has evolved to include using an extracardiac conduit with aggressive presumptive treatment of associated lesions either in the catheterization laboratory or the operating room. Fenestration is used selectively based on hemodynamics, anatomy, and presence of associated lesions. We reviewed our experience to determine the effectiveness and outcome of this strategy and to assess the cumulative trauma to the patients. The records of 137 consecutive patients who underwent Fontan at Miami Children's Hospital from 1995 to 2008 were reviewed. At mean follow up of 5.76years, freedom from death or transplantation is 94.2% (129/137). Median age at operation was 4.6years. Longer length of stay correlated with older operative age (P=0.0056). Pacemakers were implanted in 11.7% (16/137). Additional (not pre-Glenn or pre-Fontan) interventional catheterizations were performed in 51.8% (71/137). Additional operations were done in 10.2% (14/137). No patient has required replacement or revision of the extracardiac conduit. Our current approach to the Fontan operation provides acceptable midterm results. The pursuit of residual lesions results in a significant number of additional interventional catheterizations and operative procedures but might have an important influence on long-term survival after the Fontan procedure. The Author(s), 2011 Cardiac surgery nationallicence Cardiac catheterization/intervention nationallicence Congenital heart disease Pediatric nationallicence Hannan Robert Department of Cardiovascular Surgery, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut Zabinsky Jennifer Department of Cardiovascular Surgery, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut Salvaggio Jane Department of Cardiovascular Surgery, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut Rossi Anthony Department of Cardiology, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut Khan Danyal Department of Cardiology, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut Alonso Francisco Department of Cardiovascular Surgery, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut Ojito Jorge Department of Cardiovascular Surgery, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut Nykanen David Department of Pediatric Cardiology, Arnold Palmer Hospital for Children, Orlando, FL, USA aut Zahn Evan Department of Cardiology, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut Burke Redmond Department of Cardiovascular Surgery, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut Pediatric Cardiology Springer-Verlag 32/6(2011-08-01), 778-784 0172-0643 32:6<778 2011 32 246 https://doi.org/10.1007/s00246-011-9973-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00246-011-9973-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hannan Robert Department of Cardiovascular Surgery, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut NATIONALLICENCE 700 1- Zabinsky Jennifer Department of Cardiovascular Surgery, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut NATIONALLICENCE 700 1- Salvaggio Jane Department of Cardiovascular Surgery, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut NATIONALLICENCE 700 1- Rossi Anthony Department of Cardiology, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut NATIONALLICENCE 700 1- Khan Danyal Department of Cardiology, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut NATIONALLICENCE 700 1- Alonso Francisco Department of Cardiovascular Surgery, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut NATIONALLICENCE 700 1- Ojito Jorge Department of Cardiovascular Surgery, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut NATIONALLICENCE 700 1- Nykanen David Department of Pediatric Cardiology, Arnold Palmer Hospital for Children, Orlando, FL, USA aut NATIONALLICENCE 700 1- Zahn Evan Department of Cardiology, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut NATIONALLICENCE 700 1- Burke Redmond Department of Cardiovascular Surgery, Congenital Heart Institute at Miami Children's Hospital, 3100 SW 62nd Avenue, 33155, Miami, FL, USA aut NATIONALLICENCE 773 0- Pediatric Cardiology Springer-Verlag 32/6(2011-08-01), 778-784 0172-0643 32:6<778 2011 32 246 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer