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Improving results of the Fontan procedure in patients with heterotaxy syndrome

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dc.contributor.authorKim, Soo-Jin-
dc.contributor.authorKim, Woong-Han-
dc.contributor.authorLim, Hong Gook-
dc.contributor.authorLee, Chang-Ha-
dc.contributor.authorLee, Jae Young-
dc.date.accessioned2009-11-18T05:38:12Z-
dc.date.available2009-11-18T05:38:12Z-
dc.date.issued2006-09-26-
dc.identifier.citationAnn Thorac Surg. 2006 Oct;82(4):1245-51.en
dc.identifier.issn1552-6259 (Electronic)-
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16996916-
dc.identifier.urihttp://hdl.handle.net/10371/13086-
dc.description.abstractBACKGROUND: The Fontan operation in patients with heterotaxy syndrome has been associated with a poor prognosis. We studied whether the outcome of those patients with heterotaxy syndrome improved compared with those who did not have the syndrome after an extracardiac Fontan operation. METHODS: A retrospective review was performed on 185 patients who had undergone an extracardiac Fontan operation between 1996 and 2005. RESULTS: Sixty-two of the patients had heterotaxy syndrome (33.5%). Forty-one had right isomerism and 21 had left isomerism. Heterotaxy syndrome was commonly associated with a morphologic right ventricle (59.7%), a common atrioventricular valve (72.6%), an interrupted inferior vena cava (25.8%), a separate hepatic vein (30.6%), and extracardiac pulmonary venous drainage (16.1%). The hospital mortality rate was higher in the heterotaxy syndrome than nonheterotaxy (4.8% vs 2.4%; p = 0.05). Eight-year survivals were 91.9 +/- 3.2% in the nonheterotaxy group and 89.3 +/- 4.2 % in the heterotaxy group (p = 0.39). At 8 years, freedom from reoperation was 90.2 +/- 3.2% in the nonheterotaxy group and 78.5 +/- 6.2% in the heterotaxy group (p = 0.15). The outcomes (other than those of arrhythmia) were no different between the two groups. The incidences of early and late postoperative arrhythmia were 29.0% and 25.4%, respectively, in heterotaxy patients, and 15.4% and 10.8% in nonheterotaxy patients (p < 0.05). Bradyarrhythmia was found to be more common. During follow-up, atrioventricular valve regurgitation of more than mild was more common in heterotaxy patients (33.9% vs 18.9%; p = 0.05). CONCLUSIONS: Midterm outcomes after an extracardiac Fontan operation in heterotaxy and nonheterotaxy patients are similar, except arrhythmia and atrioventricular valve regurgitation.en
dc.language.isoenen
dc.publisherElsevieren
dc.subjectArrhythmias, Cardiac/etiologyen
dc.subjectChilden
dc.subjectChild, Preschoolen
dc.subjectFemaleen
dc.subject*Fontan Procedure/adverse effectsen
dc.subjectHeart Defects, Congenital/mortality/*surgeryen
dc.subjectHumansen
dc.subjectInfanten
dc.subjectMaleen
dc.subjectPrognosisen
dc.subjectReoperationen
dc.subjectRetrospective Studiesen
dc.subjectSurvival Analysisen
dc.subjectSyndromeen
dc.subjectTreatment Outcomeen
dc.titleImproving results of the Fontan procedure in patients with heterotaxy syndromeen
dc.typeArticleen
dc.contributor.AlternativeAuthor김수진-
dc.contributor.AlternativeAuthor김웅한-
dc.contributor.AlternativeAuthor임홍국-
dc.contributor.AlternativeAuthor이창하-
dc.contributor.AlternativeAuthor이재영-
dc.identifier.doi10.1016/j.athoracsur.2006.04.082-
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Thoracic Surgery (흉부외과학전공)Journal Papers (저널논문_흉부외과학전공)
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