We have located links that may give you full text access.
The Fontan operation. Ventricular hypertrophy, age, and date of operation as risk factors.
Journal of Thoracic and Cardiovascular Surgery 1986 December
One hundred two patients, aged 0.7 to 38 years, with a wide variety of cardiac malformations underwent the Fontan operation (1975 to April, 1985). Several different techniques were used. All but 17 had previously undergone one or more palliative operations. Follow-up information was obtained in all patients. Overall actuarial survival rate, with time zero being the time of the operation, was 63% at 6 years with no deaths after that in patients followed as long as out to 9.4 years; that for patients with tricuspid atresia was 81%. The hazard function (instantaneous risk) for death was highest immediately after operation and merged after about 6 months with a constant hazard extending as long as the patients were followed. Elevated post-repair right atrial pressure was correlated (p = 0.002) with the probability of death in the early phase, with the risk rising rapidly with pressures above 14 mm Hg. Hypertrophy of the ventricular main chamber was a risk factor for death in both the early (p = 0.007) and late (p = 0.008) phases of hazard, which explained in part the lesser risk of the Fontan operation in patients with tricuspid atresia. Younger age, but not older age, was a risk factor for early postoperative death, but this risk was neutralized by recent date of operation. Thus currently there is not a predicted increased risk associated with younger age at operation. In general, the Fontan operation should be done at a young age (2 to 4 years) to avoid increasing ventricular hypertrophy, but older age per se is not a contraindication to the operation.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app