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Mid Term Results of Fenestrated Intra-Extracardiac Fontan Procedure: Insights, Experiences and Expectations
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  • Arda Ozyuksel,
  • Baran Simsek,
  • Sener Demiroluk,
  • Murat Saygi,
  • Mehmet Bilal
Arda Ozyuksel
Medicana International Istanbul Hospital
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Baran Simsek
Medicana International Istanbul Hospital
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Sener Demiroluk
Medicana International Istanbul Hospital
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Murat Saygi
Medicana International Istanbul Hospital
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Mehmet Bilal
Medicana International Istanbul Hospital
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Abstract

Background: Intraextracardiac Fontan procedure aimed to combine the advantages of lateral tunnel and extracardiac conduit modifications of the original technique. Herein, we present our experience in our patients with intraextracardiac fenestrated Fontan Procedure. Methods: A retrospective analysis was performed in order to evaluate intraextracardiac fenestrated Fontan patients between 2014 and 2021. Seventeen patients were operated on with a mean age and body weight of 9.1 ± 5.5 years and 28.6 ± 14.6 kg. Results: Sixteen patients (94%) were palliated as univentricular physiology with hypoplasia of one of the ventricles. One patient (6%) with well-developed two ventricles with double outlet right ventricle and complete atrioventricular septal defect had straddling of the chordae prohibiting a biventricular repair. All of the patients had cavopulmonary anastomosis prior to Fontan completion, except one case. Fenestration was performed in all cases. Postoperative mean pulmonary artery pressures and arterial oxygen saturation levels at follow up were 10 ± 2.4 mmHg and 91.3 ± 2.7 %, respectively. Mean duration of pleural drainage was 5.4 ± 2.3 days. All of the fenestrations are patent at a mean follow up period of 4.8 ± 7.7 years, except one case. Any morbidity and mortality were not encountered. Conclusions: The mid-term results of intraextracardiac fenestrated Fontan procedure are encouraging. This procedure may improve the results in a patient population who should be palliated as univentricular physiology, especially in cases with complex cardiac anatomy.

Peer review status:UNDER REVIEW

27 Nov 2021Submitted to Journal of Cardiac Surgery
29 Nov 2021Submission Checks Completed
29 Nov 2021Assigned to Editor
29 Nov 2021Reviewer(s) Assigned
03 Dec 2021Review(s) Completed, Editorial Evaluation Pending
06 Dec 2021Editorial Decision: Revise Major
18 Dec 20211st Revision Received
05 Jan 2022Submission Checks Completed
05 Jan 2022Assigned to Editor
05 Jan 2022Reviewer(s) Assigned
17 Jan 2022Review(s) Completed, Editorial Evaluation Pending