Long-term results of Fontan procedure in 43 patients

Abstract

Background: The Fontan operation eliminates the systemic hypoxemia and ventricular volume overload characteristic of prior forms of palliation, however, late outcome of systemic venous and right atrial hypertension were unknown when the procedure was initially proposed.
Aim: We assessed the late mortality and the present clinical status atresia and other forms of univentricular heart who had modified Fontan procedure performed between 1981 and 1998, and survived early perioperative period.
Methods: We reviewed the clinical records of 43 early survivors of the modified Fontan procedure. Patients' outcome and late mortality rates were determined and present clinical status was ascertained in all patients.
Results: Late overall survival was 76.8%. Reoperation and late complication rates steadily declined according to surgery modification and homografts exclusion. Late mortality was increased only in patients with important atrio-ventricular valve dysfunction and valve replacement. Ninety seven percent of surviving patients are currently in New York Heart Association class I or II.
Conclusions: Our 20-year experience with modified Fontan procedure for tricuspid atresia and various forms of univentricular heart has resulted in improved outcome with most survivors now leading lives of good quality into adulthood.