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11 Years of the Fontan operation at a single institution: Results from 87 consecutive patients
Author(s) -
Al Absi Hebah S.,
Kiraly Laszlo,
Mora Bassem,
Al Zoebie Lama,
Al Shehhi Shaikha,
Talo Haitham
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14425
Subject(s) - medicine , fontan procedure , confidence interval , univariate analysis , odds ratio , intensive care unit , surgery , survival rate , cardiology , multivariate analysis , heart disease
Fontan procedure is the preferred palliation for patients with single ventricles. Objectives To evaluate early morbidity and mortality after Fontan operation in 87 consecutive patients, between 2007 and 2017. Methods Early survival, duration of intensive care unit (ICU), and hospital stays were the main outcomes evaluated. Potential influencing factors evaluated included preoperative and intraoperative variables. Results Fontan procedure was performed at a median age of 4.2 years (range, 17 months‐26 years), and a median weight of 15.5 kg (range, 8‐72 kg). Extracardiac Fontan was the procedure of choice. The median cardiopulmonary bypass time was 122 minutes (range, 58‐550 minutes). The majority had a fenestration (75 out of 87). Postoperatively, the median duration of ICU stay and total hospital stay were (4, 1‐76 days) and (16, 1‐85 days), respectively. Fontan failure occurred in one patient (1%). Overall early survival was 94%, resulting in a mortality rate of 6%. Univariate analysis showed that heterotaxy (odds ratio [OR], 2.222; confidence interval [CI], 1.345‐6.250; P = .003) and decreased ventricular function (OR, 2.207; CI, 1.348‐6.061; P = .002) significantly decreased survival. The same analysis failed to identify any statistically significant risk factors for prolonged hospital and ICU stays. Conclusion Our reported mortality and morbidity rates compared favorably with the reported rates. Therefore, Fontan operation can be performed in a tertiary care center in the United Arab Emirates with favorable early postoperative outcomes.