Early and Medium-Term Results after Modified Fontan Operation in Adults

Abstract

Purpose: We evaluated the early and mid-term results of Fontan operation in adults.
Methods: Since January 1998 until July 2012，a total of 6 patients (3 male and 3 female) totally underwent Fontan operation at our institution. The age was 22 ± 5 years (range 17-31). Operation methods，pre and postoperative catheterizationresult，New York Heart Association classification (NYHA)，cardio-thoracic ratio，BNP and liver function were retrospectively reviewed from patients’ medical records.
Result: There were no hospital deaths. All patients have been doing well. Four patients underwent primary Fontan surgery, and other 2 patients underwent staged bidirectional Glenn surgery. We performed 5 extracardiac conduit Fontan procedures and 1 intra cardiac conduit procedure without fenestration. Preoperative mean pulmonary artery pressure，pulmonary arterial resistance，and pulmonary arterial index were 12 ± 3mmHg，1.05 ± 0.61U/m²，and 443 ± 152, respectively. In all patients, the cardiac function was well preserved，no atrio-ventricular valve regurgitation was seen, and NYHA class improved from II to I. There was no remarkable change in cardio-thoracic ratio，BNP or liver function during 10 years of follow-up after the operation.
Conclusion: Our results indicate that adults can safely undergo the Fontan operation the same as children. However，careful follow-up is necessary since the long-term results are unknown.