Abstract:
BACKGROUND:The Fontan palliation is associated with numerous complications during long-term. The Fontan conversion operation has been advocated as an option to avoid some of these problems by converting classical Fontan types to modern forms of the circulation. Early mortality of Fontan conversion, however, remains unclear as available reports include limited numbers of patients and the results are heterogeneous. METHODS:We reviewed all original articles from 1994 to 2016 reporting Fontan conversion operations. Reports were analysed with specific reference to patient demographics, patient number, concomitant arrhythmia surgery, pacemaker implantation and early mortality. RESULTS:Overall, 37 Fontan conversion studies with a total of 1182 patients were analysed, including 35 single-centre studies and 2 registers. In the 35 single-centre studies the average age at the time of conversion was 21.6years (range 10.2-30.9years). Concomitant arrhythmia operation was performed in 71.6% of patients and concomitant pacemaker implantation procedure was performed in 59.3% of patients. Early mortality varied greatly between publications ranging from 0 to 21%. Based on a random and a fixed effect model mean mortality was 5.3% and 6.2%, respectively. Lower mortality was observed in series including younger patients at the time of conversion (average age<20years, 4.6%) and in the highest volume centre (1.4%). CONCLUSION:Fontan conversion carries a substantial mortality risk. However, results vary between centres. Overall, the combination with arrhythmia surgery seems to be associated with lower early mortality especially when patients are referred at an earlier age and are treated at highly experienced centres.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Brida M,Baumgartner H,Gatzoulis MA,Diller GPdoi
10.1016/j.ijcard.2017.01.111subject
Has Abstractpub_date
2017-06-01 00:00:00pages
132-137eissn
0167-5273issn
1874-1754pii
S0167-5273(16)34513-2journal_volume
236pub_type
杂志文章,meta分析,评审abstract::When writing a review manuscript, choosing among potentially citable references is an arduous task. Decisions are commonly based on several aspects, ranging from obvious content relevance, passing through impact factor of the journal in which a prospective citable article was written, and reaching to sovereign persona...
journal_title:International journal of cardiology
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abstract::Coronary perforation is a rare complication of percutaneous coronary intervention. We report a case of left anterior descending artery osteal perforation that led to acute cardiac tamponade during excimer laser angioplasty. Perforation was successfully covered with a PTFE-coated stent with preserved distal coronary fl...
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pub_type: 杂志文章,多中心研究,随机对照试验
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