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Fontan Procedure in Patients with Preoperative Mean Pulmonary Artery Pressure Over 15 mmHg
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  • Arda Ozyuksel,
  • Baran Simsek,
  • Omer Ozden,
  • Sener Demiroluk,
  • Murat Saygi,
  • Mehmet Bilal
Arda Ozyuksel
Biruni University

Corresponding Author:[email protected]

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Baran Simsek
Medicana International Istanbul Hospital
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Omer Ozden
Medicana International Istanbul Hospital
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Sener Demiroluk
Medicana International Istanbul Hospital
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Murat Saygi
Medicana International Istanbul Hospital
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Mehmet Bilal
Medicana International Istanbul Hospital
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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 in order 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 of the patients had stage II cavopulmonary anastomosis prior to Fontan completion, with a mean interstage period of 4 ± 2.6 years. Fontan completion was achieved with a polytetrafluorethylene (PTFE) tubular conduit, two of which were intra-extracardiac. Fenestration was performed in 4 (25%) cases. Postoperative pulmonary artery pressures and arterial oxygen saturation levels were 11.2 ± 2.8 mmHg and 97.8 ± 2, 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 mid-term results of stage III Fontan completion in patients with pulmonary artery >15 mmHg are encouraging. Pulmonary vascular resistance, not only pulmonary artery pressure may help to identify high risk patients before Fontan completion.
30 Aug 2020Submitted to Journal of Cardiac Surgery
31 Aug 2020Submission Checks Completed
31 Aug 2020Assigned to Editor
09 Nov 2020Reviewer(s) Assigned
09 Nov 2020Review(s) Completed, Editorial Evaluation Pending
09 Nov 2020Editorial Decision: Accept