The roles of Antegrade-Flow in Extra-Cardiac Fontan completion

Phạm Hữu Minh Nhựt, Trần Quyết Tiến

Main Article Content

Abstract

Background: In Fontan completion for functional single ventricles, the roles of antegrade-flow still have a lot of controversies about effects and influences to surgical results.


 Objective: we study the roles of Antegrage-Flow in Extra-cardiac Fontan completion.


Method: perspective study, serial cases.


Results: From 05/2015 to 01/2019, 122 patients underwent Extra-cardiac Fontan completions at the Heart Institution of Ho Chi Minh city. Antegrade-flows were maintained in 58 patients. Patients with antegrade-flow had significantly higher mean ages at operation, mean SpO2, mean pulmonary pressures, mean Nakata indices and mean McGoon indices than those without antegrade-flows. Antegrade-Flows did not increase hospital mortality and morbidity.


 Conclusion: Antegrade-Flow can possibly develop good pulmonary arterial branches, avoid of pulmonary branches extension and does not increase morbidity and mortality of ECC- Fontan completion.

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References

1. Jonas RA, Single Ventricle, in Comprehensive Surgical Management of Congenital Heart Disease. 2004, Hodder Arnold: London. p. 357-385.
2. Ferns, S.J., et al., Is additional pulsatile pulmonary blood flow beneficial to patients with bidirectional Glenn? J Thorac Cardiovasc Surg, 2013. 145(2): p. 451-4.
3. Corno, A.F., Editorial: Univentricular Heart. Frontiers in Pediatrics, 2015. 3(75).
4. Talwar, S., et al., Exercise performance after univentricular palliation. Annals of Pediatric Cardiology, 2018. 11(1): p. 40-47.
5. Sughimoto, K., et al., Forward Flow Through the Pulmonary Valve After Bidirectional Cavopulmonary Shunt Benefits Patients at Fontan Operation. Ann Thorac Surg, 2015. 100(4): p. 1390-6; discussion 1396-7.
6. Zhang, T., et al., Uncontrolled Antegrade Pulmonary Blood Flow and Delayed Fontan Completion After the Bidirectional Glenn Procedure: Real-World Outcomes in China. The Annals of Thoracic Surgery, 2016. 101(4): p. 1530-1538.
7. Casella, S.L., et al., Targeted Increase in Pulmonary Blood Flow in a Bidirectional Glenn Circulation. Seminars in Thoracic and Cardiovascular Surgery, 2018. 30(2): p. 182-188.
8. Tran, D.D., et al., Predictors of Prolonged Pleural Effusion After the Extracardiac Fontan Procedure: A 8-Year Single-Center Experience in Resource-Scare Setting. Pediatr Cardiol, 2020.
9. Chowdhury, U., et al., Bidirectional Glenn with interruption of antegrade pulmonary blood flow: Which is the preferred option: Ligation or division of the pulmonary artery? Annals of Cardiac Anaesthesia, 2016. 19(3): p. 561-563.
10. Li, D., et al., Successful transcatheter closure of residual ventriculopulmonary blood flow with muscular VSD occluder after ligation of pulmonary trunk in Fontan procedure. International Journal of Cardiology, 2015. 191: p. 277-278.