According to the National Heart Lung and Blood Institute, more than 30,000 newborns in the United States are born with Congenital Heart Defects (CHDs) every year. The Total Cavo-pulmonary Connection (TCPC) or the Fontan operation is a widely employed procedure to palliate CHD conditions. Two variants of this procedure are currently in use namely the intra-atrial TCPC and the extra-cardiac TCPC....

Background The outcome of the Fontan operation largely depends on patient selection because this procedure is a physiological correction. Among the several selection criteria for the Fontan operation, the importance of adequate size of the pulmonary artery remains controversial. To clarify whether or not pulmonary artery size is indispensable as one of the selection criteria for the Fontan oper...

OBJECTIVE Hemodynamic abnormalities and refractory atrial arrhythmias in patients late after the Fontan operation result in significant morbidity and mortality. We reviewed our experience with Fontan conversion and concomitant arrhythmia surgery. METHODS Between January 1996 and February 2004, 16 patients underwent Fontan conversion and arrhythmia surgery. Mean age at the initial Fontan opera...

BACKGROUND Outcomes of patients undergoing cavopulmonary palliation for single ventricle physiology may be impacted by living at altitude, as the passive pulmonary circulation is dependent on the resistance of the pulmonary vascular bed. The objective of this study is to identify risk factors for failure of cavopulmonary palliation at elevated altitude. METHODS AND RESULTS Between January 199...

BACKGROUND The success of a Fontan circulation depends on several factors including low pulmonary vascular resistance. Pulmonary vascular resistance rises in response to hypoxia. Hypoxia is associated with altitude. Therefore, we wondered whether altitude is a risk factor for early failure after the Fontan operation. The aim was to test this hypothesis. METHODS Data were obtained from all pub...

PURPOSE To investigate how blood lactate concentration changes in the early postoperative course after the Fontan procedure, and whether such a change is associated with postoperative hemodynamics. MATERIALS AND METHODS Eight pediatric patients who underwent the Fontan procedure for congenital heart disease were included. Enrollment criteria were body weight >10 kg and staged Fontan procedure...

BACKGROUND Hypoplastic left heart syndrome (HLHS) is an etiologically multifactorial congenital heart disease affecting one in 5,000 newborns. Thirty years ago there were no treatment options for this pathology and the natural course of the disease led to death, usually within the first weeks of life. Recently surgical palliative techniques have been developed allowing for a five-year survival ...

OBJECTIVE To show possible alternative uses of the Rashkind ductal umbrella. DESIGN Descriptive study of selected, non-randomised patients; with specific congenital heart lesions other than an arterial duct. SETTING A tertiary referral centre. PATIENTS Nine patients with congenital heart lesions; four with interatrial communications after a fenestrated Fontan procedure two with large aort...