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Fontan Operation. Hemodynamic Factors Associated With Postoperative Outcomes. [artículo]

Por: Albert de la Torre, Leticia [Pediatría] | Boni, Lorenzo [Cirugía Cardiaca] | Comas Illas, Juan Valentín [Cirugía Cardíaca Pediátrica] | Granados Ruiz, Miguel Ángel [Pediatría] | Herrera Linde, María Dolores [Cardiología] | Mendoza Soto, Alberto [Pediatría] | Pérez Martínez, Ana [Cardiología] | Ramos Casado, María Victoria [Pediatría] | Ruiz Alonso, Enrique [Cirugía Cardiovascular] | Velasco Bayón, José Manuel [Cardiología].
Colaborador(es): Servicio de Pediatría-Neonatología | Unidad de Cuidados Intensivos Pediátricos.
Editor: Revista Española de Cardiología (English Edition), 2012Descripción: 65(4):356-62.Recursos en línea: Solicitar documento Resumen: Introduction and objectives: The Fontan operation is usually the final palliative procedure in patients with univentricular heart. The objectives of this study were, firstly, to describe the clinical and haemodynamic characteristics of a group of patients with univentricular physiology who had previously been palliated with a bidirectional Glenn procedure and, secondly, to identify risk factors that can influence postoperative outcomes after the Fontan operation. Methods: Retrospective study with 32 patients who underwent a Fontan operation between March 2000 and December 2009. Clinical characteristics, catheterization data, type and duration of surgery were revised and analyzed as predictors of postoperative outcome. Results: Hospital mortality was 3%. After a median follow-up of 44 months (interquartile range, 32-79), survival was 90%. Preoperative mean pulmonary arterial pressure (measured during catheterization) was correlated with late mortality. Of the remaining variables analyzed, the Nakata and McGoon indices, and duration of cardiopulmonary bypass showed the highest correlations with postoperative outcomes. Interventional catheterization before the Fontan operation was performed in 42% of patients. Conclusions: Hospital mortality after the Fontan operation was very low. The performance of a haemodynamic study before the Fontan operation made it possible to select high-risk patients for surgery as well as permitting the performance of interventional procedures that could improve postoperative outcome in these patients.
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Formato Vancouver:
Mendoza A, Albert L, Ruiz E, Boni L, Ramos V, Velasco JM, et al. Fontan operation. Hemodynamic factors associated with
postoperative outcomes. Rev Esp Cardiol (Engl Ed). 2012 Apr;65(4):356-62.

PMID: 22325935

Contiene 37 referencias

Introduction and objectives: The Fontan operation is usually the final palliative procedure in patients with univentricular heart. The objectives of this study were, firstly, to describe the clinical and haemodynamic characteristics of a group of patients with univentricular physiology who had previously been palliated
with a bidirectional Glenn procedure and, secondly, to identify risk factors that can influence postoperative outcomes after the Fontan operation.
Methods: Retrospective study with 32 patients who underwent a Fontan operation between March 2000 and December 2009. Clinical characteristics, catheterization data, type and duration of surgery were revised and analyzed as predictors of postoperative outcome.
Results: Hospital mortality was 3%. After a median follow-up of 44 months (interquartile range, 32-79), survival was 90%. Preoperative mean pulmonary arterial pressure (measured during catheterization) was correlated with late mortality. Of the remaining variables analyzed, the Nakata and McGoon indices,
and duration of cardiopulmonary bypass showed the highest correlations with postoperative outcomes.
Interventional catheterization before the Fontan operation was performed in 42% of patients.
Conclusions: Hospital mortality after the Fontan operation was very low. The performance of a haemodynamic study before the Fontan operation made it possible to select high-risk patients for
surgery as well as permitting the performance of interventional procedures that could improve postoperative outcome in these patients.

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