MODIFIED FONTAN OPERATION FOR COMPLEX CARDIAC ANOMALIES : Postoperative Hemodynamics, Cardiac Function and Clinical Status
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概要
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The purpose of this paper is to compare and define the postoperative hemodynamics, cardiac function and clinical status after the modified Fontan operation in patients with complex cardiac anomalies. Thirteen consecutive patients (6 with double-outlet right ventricle [DORV] [SLL : 4, SDL : 2], 5 with single ventricle [SV] [A-III : 3, B-III : 1, C-III : 1] and 2 with tricuspid atresia [TA] [ Ib : 1, IIb : 1]) underwent the modified Fontan operation. These 13 patients ranging in age from 7 to 42 years of age (mean 18) were catheterized at 7 to 46 months (mean 8 months) postoperatively. Pressure tracings at rest demonstrated a dominant "a" wave in both the right atrium and the pulmonary artery suggesting a marked right atrial contraction after this operation. Left ventricular filling pressure was significantly decreased after the modified Fontan operation in DORV and SV. The ejection fraction and left ventricular end-diastolic volume index were unchanged or slightly increased after the modified Fontan operation. Cardiac index in 6 patients with DORV was significantly increased from rest to exercise by +48% (p 0.05) with a significant increase in the stroke volume (p 0.05) and with a slight increase in heart rate, but this index in 5 patients with SV and in 2 patients with TA was not significantly increased from rest to exercise. In the postoperative clinical status, 11 of 13 patients were in NYHA class I and 2 in class II at follow-up periods ranging from 4 to 75 months (mean 48 months). These results suggest that the modified Fontan operation can be of value and can provide excellent exercise tolerance for patients with complex cardiac lesions.
- 社団法人日本循環器学会の論文
- 1988-11-20
著者
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ABE Tomio
Department of Thorac.& Cardiovas.Surgery,Sapporo Medical College
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SUGIKI Kenji
Department of Thorac.& Cardiovas.Surgery,Sapporo Medical College
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Abe Tomio
The Department Of Surgery (section 2) Sapporo Medical University And Hospital
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Sugiki Kenji
Depart. Of Thoracic And Cardiovascular Surgery Sapporo Medical College
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Sugiki Kenji
Second Department Of Surgery Sapporo Medical College
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Komatsu Sakuzo
The Department Of Surgery (section 2) Sapporo Medical University And Hospital
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Komatsu Sakuzo
Dept. Of Cardio-thoracic Surgery Sapporo Medical College And Hospital
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Komatsu Sakuzo
Department Of Surgery Section 2 Sapporo Medical College & Hospital
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Komatsu Sakuzo
Second Department Of Surgery Sapporo Medical College
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Komatsu Sakuzo
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical College And Hospital
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Sugiki Kenji
Department Of Thoracic & Cardiovascular Surgery Sapporo Medical College & Hospital
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SUGIKI Kenji
Cardiovascular Center Hokkaido Ohno Hospital
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Komatsu Sakuzo
Department Of Thorac.& Cardiovas.surgery Sapporo Medical College
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Komatsu Sakuzo
Department Of Surgery (section 2) Sapporo Medical College And Hospital
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Abe Tomio
Department Of Surgery (section 2) Sapporo Medical College And Hospital
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Abe Tomio
Department Of Cardiothoracic Surgery Sapporo Medical University
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Sugiki Kenji
Dept. Of Thoracic & Cardiovascular Surgery Sapporo Medical Collage
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Abe Tomio
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical University Hospital
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Komatsu Sakuzou
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical College
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