The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 5 , Pages 1183-1188 , May 2010

Avoiding cardiopulmonary bypass in extracardiac cavopulmonary connection: Does it really matter?

  • Mohammad Ali Navabi, MD

      Affiliations

    • Department of Pediatric Cardiac Surgery, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
    • Corresponding Author InformationAddress for reprints: Mohammad Ali Navabi, MD, Department of Pediatric Cardiac Surgery, Imam Hospital, 62 Gharib St, 14194, Tehran, Iran.
    • ,
  • Saideh M. Rastegar, MSN

      Affiliations

    • Department of Pediatric Cardiac Surgery, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
    • ,
  • Abdolrazagh Kiani, MD

      Affiliations

    • Department of Pediatric Cardiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
    • ,
  • Mahmood Gholam Ale Mohammad, MD

      Affiliations

    • Department of Pediatric Cardiac Surgery, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
    • ,
  • Parvin Akbari Asbagh, MD

      Affiliations

    • Department of Pediatric Cardiac Surgery, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
    • ,
  • Mohammad Reza Mirzaaghayan, MD

      Affiliations

    • Department of Pediatric Cardiac Surgery, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
    • ,
  • Ali Pasha Meysamie, PhD

      Affiliations

    • Department of Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
    • ,
  • Reza Shabanian, MD

      Affiliations

    • Department of Pediatric Cardiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran

Received 29 July 2009 ,Revised 16 September 2009 ,Accepted 16 October 2009.

References 

  1. Fontan F, Baudet E. Surgical repair of tricuspid atresia. Thorax. 1971;26:240–248
  2. Hosein RB, Clarke AJ, McGuirk SP, Griselli M, Stumper O, De Giovanni JV, et al. Factors influencing early and late outcome following the Fontan procedure in the current era. The “two commandments”?. Eur J Cardiothorac Surg. 2007;31:344–352
  3. Mitchell ME, Ittenbach RF, Gaynor JW, Wernovsky G, Nicolson S, Spray TL. Intermediate outcomes after the Fontan procedure in the current era. J Thorac Cardiovasc Surg. 2006;131:172–180
  4. Yoshimura N, Yamaguchi M, Oshima Y, Oka S, Ootaki Y, Tei T, et al. Risk factors influencing early and late mortality after total cavopulmonary connection. Eur J Cardiothorac Surg. 2001;20:598–602
  5. Alphonso N, Baghai M, Sundar P, Tulloh R, Austin C, Anderson D. Intermediate-term outcome following the Fontan operation: a survival, functional and risk-factor analysis. Eur J Cardiothorac Surg. 2005;28:529–535
  6. Uemura H, Yagihara T, Yamashita K, Ishizaka T, Yoshizumi K, Kawahira Y. Establishment of total cavopulmonary connection without use of cardiopulmonary bypass. Eur J Cardiothorac Surg. 1998;13:504–507
  7. McElhinney DB, Petrossian E, Reddy VM, Hanley FL. Extracardiac conduit Fontan procedure without cardiopulmonary bypass. Ann Thorac Surg. 1998;66:1826–1828
  8. Tam VK, Miller BE, Murphy K. Modified Fontan without use of cardiopulmonary bypass. Ann Thorac Surg. 1999;68:1698–1703
  9. Yetman AT, Drummond-Webb J, Fiser WP, Schmitz ML, Imamura M, Ullah S, et al. The extracardiac Fontan procedure without cardiopulmonary bypass: technique and intermediate-term results. Ann Thorac Surg. 2002;74:S1416–S1421
  10. Petrossian E, Reddy VM, Collins KK, Culbertson CB, MacDonald MJ, Lamberti JJ, et al. The extracardiac conduit Fontan operation using minimal approach extracorporeal circulation: early and midterm outcomes. J Thorac Cardiovasc Surg. 2006;132:1054–1063
  11. Tireli E, Ugurlucan M, Basaran M, Kafali E, Harmandar B, Sayin OA, et al. Extracardiac Fontan operation without cardiopulmonary bypass. J Cardiovasc Surg (Torino). 2006;47:699–704
  12. Welke KF, Shen I, Ungerleider RM. Current assessment of mortality rates in congenital cardiac surgery. Ann Thorac Surg. 2006;82:164–170
  13. Kumar SP, Rubinstein CS, Simsic JM, Taylor AB, Saul JP, Bradley SM. Lateral tunnel versus extracardiac conduit Fontan procedure: a concurrent comparison. Ann Thorac Surg. 2003;76:1389–1396
  14. Shikata F, Yagihara T, Kagisaki K, Hagino I, Shiraishi S, Kobayashi J, et al. Does the off-pump Fontan procedure ameliorate the volume and duration of pleural and peritoneal effusions?. Eur J Cardiothorac Surg. 2008;34:570–575
  15. Abu-Omar Y, Cader S, Guerrieri Wolf L, Pigott D, Matthews PM, Taggart DP. Short-term changes in cerebral activity in on-pump and off-pump cardiac surgery defined by functional magnetic resonance imaging and their relationship to microembolization. J Thorac Cardiovasc Surg. 2006;132:1119–1125
  16. Mainwaring RD, Lamberti JJ, Hugli TE. Complement activation and cytokine generation after modified Fontan procedure. Ann Thorac Surg. 1998;65:1715–1720
  17. Gupta A, Daggett C, Behera S, Ferraro M, Wells W, Starnes V. Risk factors for persistent pleural effusions after the extracardiac Fontan procedure. J Thorac Cardiovasc Surg. 2004;127:1664–1669
  18. Kostelka M, Hucín B, Tláskal T, Chaloupecký V, Reich O, Janousek J, et al. Bidirectional Glenn followed by total cavopulmonary connection or primary total cavopulmonary connection?. Eur J Cardiothorac Surg. 1997;12:177–183
  19. Manning PB, Mayer JE, Wernovsky G, Fishberger SB, Walsh EP. Staged operation to Fontan increases the incidence of sinoatrial node dysfunction. J Thorac Cardiovasc Surg. 1996;111:833–839
  20. Lemler MS, Scott WA, Leonard SR, Stromberg D, Ramaciotti C. Fenestration improves clinical outcome of the Fontan procedure: a prospective, randomized study. Circulation. 2002;105:207–212
  21. Bridges ND, Lock JE, Castaneda AR. Baffle fenestration with subsequent transcatheter closure. Modification of the Fontan operation for patients at increased risk. Circulation. 1990;82:1681–1689
  22. Kim SJ, Kim WH, Lim HG, Lee JY. Outcome of 200 patients after an extracardiac Fontan procedure. J Thorac Cardiovasc Surg. 2008;136:108–116

 Disclosures: None.

PII: S0022-5223(09)01396-8

doi: 10.1016/j.jtcvs.2009.10.031

The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 5 , Pages 1183-1188 , May 2010

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