EXPERIENCE OF FONTAN SURGERY AT ARMED FORCES INSTITUTE OF CARDIOLOGY /NATIONAL INSTITUTE OF HEART DISEASES (AFIC-NIHD)

Abstract

Objective: To assess the overall outcome and success of Fontan surgery at our institute.
Place and Duration of study: AFIC-NIHD Rawalpindi. 01 September 2005 to 31 March 2010.
Patients and Methods: For this retrospective study, institute’s cardiac surgery database was used. Patients of single ventricle physiology, who had normal Left Ventricular End-diastolic Pressure and pulmonary artery pressures, were included. Data was analyzed using SPSS version 16.
Results: A total of 34 Fontan procedures were done. The mean age at operation was 4.83±1.37 years. There were 22(64.7%) males and 12(35.3%) females. Twenty five (73.5%) had a staged Fontan (successful previous Bidirectional Glenn’s shunt, BDG). Nine (26.5%) were primary Fontan procedures (no successful previous Bidirectional Glenn’s shunt, BDG). Thirty two (94.8%) were Extra Cardiac Conduit Fontan (ECCF) and 2(5.8%) were Intra Cardiac Fontan. Mean Bypass time was 132.65±48.44 minutes. Aorta was cross clamped in intracardiac Fontan and its mean time was 43.31±5.85minutes. Fenestration was employed in 14(41.2%) patients. Mean pre-operative oxygen saturations were 77.41±10.27%, which significantly increased to 93.94± 3.96 % post-operatively (p<0.001). In-hospital mortality was 2(5.8 %).
Conclusion: Fontan surgery has acceptable morbidity and mortality in our set up.