The authors measured serum amino-terminal procollagen III (PIII) as a marker of myocardial fibrogenesis in patients undergoing the Fontan procedure for single ventricle circulation and in controls. Patients with single venticle circulation had elevated PIII levels compared to controls. Staged Fontan elements successively reduced PIII levels. The
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Single ventricle and palliative procedures
April 12, 2016
Results of an audit of the National Congenital Heart Disease database were evaluted to determine characteristics of patients undergoing reoperation within 30 days of their primary procedure. Among over 18,000 patients, 3.5% had early reoperations. The reoperations were most commonly arterial shunt, PA band, and VSD procedures. 60 day mortality was
February 8, 2016
This video shows a primary inferior cavopulmonary connection with an extracardiac conduit as an alternative treatment for an infant unsuitable for the bidirectional Glenn.
December 24, 2015
The impact of combined mitral stenosis and aortic atresia on outcomes of Norwood procedures for hypoplastic left heart syndrome was examined in a single institution. The incidence among 74 operated patients was 19%. Mortality for affected patients was 29% vs 7% for the other patients. The mechanism of mortality appeared to be myocardial ischemia.
April 30, 2015
Results of AV valve surgery in patients with Fontan circulation were evaluated over a 23 year period. 54 (9.3%) of patients requird AV valve surgery, mostly prior to the Fontan operation. 90% of patients were free from death or transplantation at 5 years; this fell to 81% at 10 years. Nearly 45% required AV valve reoperation. The rate of persis
January 12, 2015
The single-centre study analyses 257 Norwood procedures. Patients older than 20 days were at higher risk for early postoperative mortality, postoperative pulmonary hypertensive and impaired cardiac function.
January 10, 2015
Patients who underwent a Fontan procedure for single ventricle physiology were evaluated with serial cardiac MR over time to identify changes in vessel characteristics and their relationship to flow. Although vessel diameter increased over time, normalized diameters decreased. This was not associated with changes in flow, but hemodynamic efficiency
January 5, 2015
August 5, 2014
The formation of endotracheal casts comprised of inflammatory debris (plastic bronchitis) is a rare but life-threatening complication of the Fontan procedure. This summary of 14 pts so affected demonstrated a mean interval to development of plastic bronchitis of 1.5 years. Casts were treated with outpt t-PA (13 pts) and pulmonary vasodilators. Les
April 7, 2014
This video demonstrates the conduct of a novel beating-heart Norwood operation. The procedure is universally-applicable to even the smallest aortas.