Why the study?
What are the mortality and functional outcomes of the modified Fontan operation in patients with complex congenital heart lesions?
What are the mortality and functional outcomes of the modified Fontan operation in patients with complex congenital heart lesions?
The modified Fontan operation can be performed with low early mortality and yields encouraging short-term functional outcomes in appropriately selected patients.
May support modified Fontan use in selected complex lesions; leaves open long-term durability assessment.
From Jan 1989 to December 1991, 61 patients had modified Fontan procedures for a variety of lesions, including tricuspid atresia (18), mitral atresia (3), double inlet ventricle (14), isomeric hearts (4) and others (22). The hospital mortality was 1.6% (70% CL.0.2-5.3%). There were 2 late deaths. The median age at operation was 3.7 years (mean 5.6, range 1.5 to 20.3 years). There were two late failures at 2 months and 30 months after the operation, requiring take down of the Fontan in one and heart transplantation in the other. The 89% of the patients followed up are in NYHA class I or II at a mean follow up of 21.5 months (range 3-35 months). This suggests that the modified Fontan operation performed with the current patient selection criteria can be performed with a low mortality and that the early results are encouraging in the majority of the patients.
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Malm et al. (1993) studied this question.
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