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Fontan procedure in patients with preoperative mean pulmonary artery pressure over 15 mmHg

2021; Wiley; Volume: 36; Issue: 3 Linguagem: Inglês

10.1111/jocs.15293

1540-8191

Arda Özyüksel, Baran Şimşek, Ömer Özden, Şener Demiroluk, Murat Saygı, Mehmet Salih Bilal,

Tracheal and airway disorders

Journal of Cardiac SurgeryVolume 36, Issue 3 p. 941-949 ORIGINAL ARTICLE Fontan procedure in patients with preoperative mean pulmonary artery pressure over 15 mmHg Arda Özyüksel MD, Corresponding Author Arda Özyüksel MD Assoc. Prof. ozyukselarda@yahoo.com orcid.org/0000-0001-7478-6235 Department of Cardiovascular Surgery, Biruni University, Istanbul, Turkey Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, Turkey Correspondence Arda Özyüksel, MD, Assoc. Prof., Department of Cardiovascular Surgery, Medicana International Hospital, Beylikduzu Cad. No: 3, Beylikduzu, Istanbul 34520, Turkey. Email: ozyukselarda@yahoo.comSearch for more papers by this authorBaran Şimşek MD, Baran Şimşek MD Spec. Cardiovasc. Surg. orcid.org/0000-0002-9554-9498 Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, TurkeySearch for more papers by this authorÖmer Özden MD, Ömer Özden MD Spec. Pediatr. Intensive Care orcid.org/0000-0003-0297-5250 Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, TurkeySearch for more papers by this authorŞener Demiroluk MD, Şener Demiroluk MD Spec. Anesthesiol. orcid.org/0000-0001-5903-5134 Department of Anesthesiology, Medicana International Hospital, Istanbul, TurkeySearch for more papers by this authorMurat Saygı MD, Murat Saygı MD Spec. Pediatr. Cardiol. orcid.org/0000-0001-5207-3584 Department of Pediatric Cardiology, Medicana International Hospital, Istanbul, TurkeySearch for more papers by this authorMehmet Salih Bilal MD, Mehmet Salih Bilal MD Prof. orcid.org/0000-0002-9405-8179 Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, TurkeySearch for more papers by this author Arda Özyüksel MD, Corresponding Author Arda Özyüksel MD Assoc. Prof. ozyukselarda@yahoo.com orcid.org/0000-0001-7478-6235 Department of Cardiovascular Surgery, Biruni University, Istanbul, Turkey Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, Turkey Correspondence Arda Özyüksel, MD, Assoc. Prof., Department of Cardiovascular Surgery, Medicana International Hospital, Beylikduzu Cad. No: 3, Beylikduzu, Istanbul 34520, Turkey. Email: ozyukselarda@yahoo.comSearch for more papers by this authorBaran Şimşek MD, Baran Şimşek MD Spec. Cardiovasc. Surg. orcid.org/0000-0002-9554-9498 Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, TurkeySearch for more papers by this authorÖmer Özden MD, Ömer Özden MD Spec. Pediatr. Intensive Care orcid.org/0000-0003-0297-5250 Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, TurkeySearch for more papers by this authorŞener Demiroluk MD, Şener Demiroluk MD Spec. Anesthesiol. orcid.org/0000-0001-5903-5134 Department of Anesthesiology, Medicana International Hospital, Istanbul, TurkeySearch for more papers by this authorMurat Saygı MD, Murat Saygı MD Spec. Pediatr. Cardiol. orcid.org/0000-0001-5207-3584 Department of Pediatric Cardiology, Medicana International Hospital, Istanbul, TurkeySearch for more papers by this authorMehmet Salih Bilal MD, Mehmet Salih Bilal MD Prof. orcid.org/0000-0002-9405-8179 Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, TurkeySearch for more papers by this author First published: 08 January 2021 https://doi.org/10.1111/jocs.15293Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Background Several factors affect the long-term outcome of Fontan procedure, but a high pulmonary artery pressure is still one of the most important limitation for proceeding to a Fontan circulation. Herein, we present our experience in Fontan patients with high preoperative pulmonary artery pressures. Methods A retrospective analysis was performed to evaluate Fontan patients with a preoperative pulmonary artery pressure >15 mmHg between 2009 and 2020. Sixteen patients were operated on with a mean preoperative pulmonary artery pressure of 17.5 ± 2.1 mmHg. Results Mean age at the time of Fontan procedure was 7.8 ± 5.6 years. All the patients had stage 2 cavopulmonary anastomosis before Fontan completion, with a mean interstage period of 4 ± 2.6 years. Fontan completion was achieved with a polytetrafluorethylene tubular conduit, two of which were intra-extracardiac. Fenestration was performed in five (31%) cases. Postoperative pulmonary artery pressures and arterial oxygen saturation levels were 11.2 ± 2.8 and 97.8 ± 2 mmHg, respectively. Mean duration of pleural drainage was 3.9 ± 5.3 days. Any morbidity and mortality were not encountered during a mean follow-up period of 4.8 ± 7.7 years. Conclusions The midterm results of stage 3 Fontan completion in patients with pulmonary artery >15 mmHg are encouraging. Not only the mean pulmonary artery pressure but also the pulmonary vascular resistance may be helpful in order to identify the high risk patients before Fontan completion. Open Research DATA AVAILABILITY STATEMENT Data available on request due to privacy/ethical restrictions. Citing Literature Volume36, Issue3March 2021Pages 941-949 RelatedInformation