Mid Term Results of Fenestrated Intra-Extracardiac Fontan Procedure:
Insights, Experiences and Expectations
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.