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Title: The fontan operation: Experience at Siriraj Hospital
Authors: Jarupim Soongswang
Apichart Nana
Kritvikrom Durongpisitkul
Ungkab Prakanrattana
Siriluck Suriyabantheong
Burin Kaosa-Ard
Samphant Pornvilawan
Duangmanee Laohaprasitiporn
Somchai Sriyoscharti
Charuwan Kangkagate
Kanchana Wansanit
Nitaya Limpimwong
Mahidol University
Keywords: Medicine
Issue Date: 1-Oct-2000
Citation: Journal of the Medical Association of Thailand. Vol.83, No.10 (2000), 1133-1140
Abstract: Seventy five patients underwent modified Fontan operation at Siriraj Hospital from October 1987 to December 1998. Cardiology data was analyzed retrospectively. Four patients' data was unavailable. Median age at operation was 9.7 (1.8-34) years old . Tricuspid atresia accounted for 38 per cent of the patients. Ten patients (14.1%) died in the acute post operative period due to consequence of low cardiac output. Another 3 patients (4.2%) expired in the intermediate and late post operative period. Age at operation, pulmonary artery size, pre-operative oxygen saturation, and mean pre-operative pulmonary artery pressure were not different between those who survived and those who died. Abnormal pulmonary vein, atrioventricular valve regurgitation, and underlying ventricular morphology statistically affected the acute survival of modified Fontan operation. Intraoperative aortic cross clamp time, and post operative mean pulmonary artery pressure on day 0,1 and 2 post operation were found statistically shorter and lower in the survival group. Survival rate at 5 years was 83 per cent. Modified Fontan operation is the final palliative operation of choice for low risk single ventricle physiology in our institution with acceptable outcome. Thorough pre-operative hemodynamic and anatomic studies and staging modified Fontan procedure may include a higher number of candidates and improve the outcome of the operation.
ISSN: 01252208
Appears in Collections:Scopus 1991-2000

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