Fontan operation in the current era: a 15-year single institution experience.

Abstract:

OBJECTIVE:Evaluate current risk factors for mortality and morbidity in patients undergoing the Fontan procedure at a single institution in the current era. SUMMARY BACKGROUND DATA:An emphasis on early relief of volume and pressure overload culminating in the Fontan procedure has improved patient outcomes for patients with a single ventricle. METHODS:A cross-sectional retrospective study was performed for 636 primary Fontan procedures between July 1992 and June 2007. RESULTS:Anatomy included left ventricular hypoplasia in 64% and right ventricular hypoplasia in 36%. A lateral tunnel (LT) was performed in 92% and an extracardiac conduit (EC) in 8%. Hospital survival was 96%. Long-term survival was 97% at a mean follow-up of 50 months (range, 0-173 months). Ventricular anatomy and preoperative hemodynamics did not predict early or late survival. Longer aortic cross clamp (XC) time was associated with decreased late survival (P = 0.01). Fontan takedown was required in 3% and protein-losing enteropathy (PLE) developed in 6%. At follow-up, 98% of patients were either NYHA class I or II and 87% were in normal sinus rhythm. Patients with chest tube drainage >2 weeks had an increased risk of PLE (P < 0.0001) and diminished short- and long-term survival (P = 0.026 and P < 0.0001, respectively). CONCLUSIONS:The Fontan procedure can be performed with low risk regardless of ventricular anatomy. Duration of XC time is associated with survival. Prolonged CT drainage correlates with late PLE and diminished survival. There was a low prevalence of late rhythm disturbances and other complications.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Hirsch JC,Goldberg C,Bove EL,Salehian S,Lee T,Ohye RG,Devaney EJ

doi

10.1097/SLA.0b013e3181858286

subject

Has Abstract

pub_date

2008-09-01 00:00:00

pages

402-10

issue

3

eissn

0003-4932

issn

1528-1140

pii

00000658-200809000-00006

journal_volume

248

pub_type

杂志文章
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    journal_title:Annals of surgery

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    doi:10.1097/00000658-198108000-00018

    authors: Bjornson AB,Bjornson HS,Altemeier WA

    更新日期:1981-08-01 00:00:00

  • Surgical aspects of sclerosing cholangitis. Results in 178 patients.

    abstract::Of 178 patients with sclerosing cholangitis treated since 1950, 88 patients had associated inflammatory bowel disease, 72 had no such history, and 18 had iatrogenic injury or stone disease. A total of 233 biliary operations were performed, with a 75% rate of temporary improvement after initial operation. Subsequent op...

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    authors: Martin FM,Rossi RL,Nugent FW,Scholz FJ,Jenkins RL,Lewis WD,Gagner M,Foley E,Braasch JW

    更新日期:1990-10-01 00:00:00

  • A clinicopathologic study of sex cases.

    abstract::Six patients with surgically treated Menetrier's disease are presented. Diffuse or focal cystic hyperplasia of mucous secreting epithelium of the fundus with antral sparing characterized the stomachs in all of these cases. In most instances the disorder was found during evaluation of non-specific complaints of pain, n...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197704000-00015

    authors: Davis JM,Gray GF,Thorbjarnarson B

    更新日期:1977-04-01 00:00:00

  • Multiple systems organ failure. Modulation of hepatocyte protein synthesis by endotoxin activated Kupffer cells.

    abstract::The etiology of hepatic insufficiency associated with the multiple systems organ failure (MSOF) syndrome is unclear. The authors have investigated the possibility that a macrophage/Kupffer cell mediated modulation of hepatocyte function may play a role in this phenomenon. Isolated rat hepatocytes were cultured, and th...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:

    authors: Keller GA,West MA,Cerra FB,Simmons RL

    更新日期:1985-01-01 00:00:00

  • The influence of mechanical bowel preparation in elective lower colorectal surgery.

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    authors: Van't Sant HP,Weidema WF,Hop WC,Oostvogel HJ,Contant CM

    更新日期:2010-01-01 00:00:00

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    doi:10.1097/00000658-200108000-00004

    authors: Matas AJ,Payne WD,Sutherland DE,Humar A,Gruessner RW,Kandaswamy R,Dunn DL,Gillingham KJ,Najarian JS

    更新日期:2001-08-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

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    authors: Zmora O,Mahajna A,Bar-Zakai B,Rosin D,Hershko D,Shabtai M,Krausz MM,Ayalon A

    更新日期:2003-03-01 00:00:00

  • Casting A Wide Net On Surgery: The Central Role of Neutrophil Extracellular Traps.

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    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/SLA.0000000000003586

    authors: Eustache JH,Tohme S,Milette S,Rayes RF,Tsung A,Spicer JD

    更新日期:2020-08-01 00:00:00

  • Blood transfusions and prognosis in colorectal cancer: long-term results of a randomized controlled trial.

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    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

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    authors: Harlaar JJ,Gosselink MP,Hop WC,Lange JF,Busch OR,Jeekel H

    更新日期:2012-11-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200209000-00010

    authors: Delman KA,Zager JS,Bennett JJ,Malhotra S,Ebright MI,McAuliffe PF,Halterman MW,Federoff HJ,Fong Y

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    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

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    更新日期:1994-08-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章

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    更新日期:2011-01-01 00:00:00

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    authors: van Mil ACCM,Pouwels S,Wilbrink J,Warlé MC,Thijssen DHJ

    更新日期:2019-04-01 00:00:00

  • Endocrine tumors of the duodenum. Clinical characteristics and hormone content.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198304000-00003

    authors: Lasson A,Alwmark A,Nobin A,Sundler F

    更新日期:1983-04-01 00:00:00

  • Anti-TNF Therapy Is Associated With an Increased Risk of Postoperative Morbidity After Surgery for Ileocolonic Crohn Disease: Results of a Prospective Nationwide Cohort.

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    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000002017

    authors: Brouquet A,Maggiori L,Zerbib P,Lefevre JH,Denost Q,Germain A,Cotte E,Beyer-Berjot L,Munoz-Bongrand N,Desfourneaux V,Rahili A,Duffas JP,Pautrat K,Denet C,Bridoux V,Meurette G,Faucheron JL,Loriau J,Guillon F,Vicaut E

    更新日期:2018-02-01 00:00:00

  • Clinicopathological characteristics and molecular analyses of multifocal intraductal papillary mucinous neoplasms of the pancreas.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3182378a18

    authors: Matthaei H,Norris AL,Tsiatis AC,Olino K,Hong SM,dal Molin M,Goggins MG,Canto M,Horton KM,Jackson KD,Capelli P,Zamboni G,Bortesi L,Furukawa T,Egawa S,Ishida M,Ottomo S,Unno M,Motoi F,Wolfgang CL,Edil BH,Cameron J

    更新日期:2012-02-01 00:00:00

  • Vocal cord paralysis and reoperative parathyroidectomy. A prospective study.

    abstract::One hundred sixty-three patients undergoing reoperative parathyroidectomy were evaluated before and after operation to determine the incidence of, risk factors for, and morbidity of vocal cord paralysis. These patients were compared to 77 patients undergoing initial parathyroid operation, only one of whom had vocal co...

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    doi:10.1097/00000658-198603000-00011

    authors: Patow CA,Norton JA,Brennan MF

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  • The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults.

    abstract:OBJECTIVE:To develop evidence-based recommendations for safe, effective, and appropriate thyroidectomy. BACKGROUND:Surgical management of thyroid disease has evolved considerably over several decades leading to variability in rendered care. Over 100,000 thyroid operations are performed annually in the US. METHODS:The...

    journal_title:Annals of surgery

    pub_type: 杂志文章,实务指引

    doi:10.1097/SLA.0000000000003580

    authors: Patel KN,Yip L,Lubitz CC,Grubbs EG,Miller BS,Shen W,Angelos P,Chen H,Doherty GM,Fahey TJ 3rd,Kebebew E,Livolsi VA,Perrier ND,Sipos JA,Sosa JA,Steward D,Tufano RP,McHenry CR,Carty SE

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  • Pancreatic necrosis: results of necrosectomy, packing, and ultimate closure over drains.

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    pub_type: 杂志文章

    doi:10.1097/00000658-199806000-00010

    authors: Branum G,Galloway J,Hirchowitz W,Fendley M,Hunter J

    更新日期:1998-06-01 00:00:00

  • Evaluation of hepatic venous congestion: proposed indication criteria for hepatic vein reconstruction.

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    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000658-200208000-00013

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    更新日期:2002-08-01 00:00:00

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    abstract::An analysis of 584 operations for recurrent inguinal hernia was made in an attempt to determine the cause of the recurrence based on the anatomic findings. The recurrence was indirect in 300, direct in 241, and various other in 43 operations. The causes of the indirect recurrences appeared to be an unrecognized hernia...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198512000-00019

    authors: Postlethwait RW

    更新日期:1985-12-01 00:00:00

  • Surgery in Zollinger-Ellison syndrome alters the natural history of gastrinoma.

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    pub_type: 临床试验,杂志文章

    doi:10.1097/00000658-199409000-00008

    authors: Fraker DL,Norton JA,Alexander HR,Venzon DJ,Jensen RT

    更新日期:1994-09-01 00:00:00

  • A Longitudinal Assessment of Outcomes and Healthcare Resource Utilization After Immediate Breast Reconstruction-Comparing Implant- and Autologous-based Breast Reconstruction.

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    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001457

    authors: Fischer JP,Fox JP,Nelson JA,Kovach SJ,Serletti JM

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    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0b013e3181c5dc2e

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    pub_type: 杂志文章

    doi:10.1097/00000658-197601000-00017

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    doi:10.1097/SLA.0000000000004708

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    doi:10.1097/SLA.0000000000003074

    authors: White C,Weinstein MC,Fingeret AL,Randolph GW,Miyauchi A,Ito Y,Zhan T,Ali A,Gazelle GS,Lubitz CC

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    authors: Toyama MT,Patel AG,Nguyen T,Ashley SW,Reber HA

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    authors: Keck T,Wellner UF,Bahra M,Klein F,Sick O,Niedergethmann M,Wilhelm TJ,Farkas SA,Börner T,Bruns C,Kleespies A,Kleeff J,Mihaljevic AL,Uhl W,Chromik A,Fendrich V,Heeger K,Padberg W,Hecker A,Neumann UP,Junge K,Kalff

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