• Department of Pediatric Cardiovascular and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P. R. China;
CHENHui-wen, Email: hwhwhc@hotmail.com
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Objective To analyze the outcomes of patients with one-stage Fontan procedure and short-term prognosis at a single institute. Method  We retrospectively analyzed clinical records of 116 patients with one-stage Fontan procedure in our hospital from January 2008 through September 2013. There were 77 males and 39 females (36%), with median age 6.27 years (ranged 3.15 to 17.47 years) at the time of surgery and the median weight at 17.5 kg (ranged 10.0 to 80.0 kg). There were 55 patients with standard extracardiac conduit, 13 patients with direct extracardiac connection, 17 patients with intra-atrial or intra/extracardiac conduit, and 31 patients with lateral tunnel. Results Median cardiopulmonary bypass time was 124 (61-256) minutes. Median cross-clamp time was 60 (19-152) minutes. There were six early deaths (5.1%). The overall median time of the cardiac intensive care unit stay was 4 (1-17) days, with a median ventilator support of 7.3 (1.0-181.0) hours. The mean room air saturation was 90.00%±4.68% before discharge. Median length of chest tube drainage was 10 (4-45) days. Multiple logistic analysis confirmed that heterotaxy syndrome was the only independent predictor for postoperative renal insufficiency. Operations with aortic cross-clamping (OR=26.184, 95% CI 1.712-400.451), preoperative sinus mode dysfunction (OR=6.777, 95% CI 1.495-30.721) and cross-clamp time over 60 minutes (OR=1.036, 95% CI 1.002-1.076) were predictors for prolonged chest tube drainage. A total of 110 patients were followed up for 17 (8-47) months with 2 deaths and 1 with thrombosis. No reoperation occurred. Conclusion The one-stage Fontan procedure can be performed with satisfactory outcomes. Staged strategies for operations may be appropriately loosen for selected elder children.

Citation: LIUWei, LIUJin-fen, XUZhi-wei, ZHANGHai-bo, ZHENGJing-hao, ZHUZhong-qun, YANQin, WANGShun-min, QIULi-sheng, ZHUHong-bing, LUYa-nan, CHENHui-wen. Medical Results of One-stage Fontan Procedure in 116 Patients at A Single Institute. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(2): 142-146. doi: 10.7507/1007-4848.20160032 Copy

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