Share this page on LinkedIn
Share This Page on Google+
Share This Page on Twitter
tell someone about this page print this page
You are here: Contents > 2004 > Volume 13 Number 6 November 2004 > TRICUSPID VALVE DISEASE > Intermediate Outcomes of Atrioventricular Valvuloplasty in Lateral Tunnel Fontan Patients

Intermediate Outcomes of Atrioventricular Valvuloplasty in Lateral Tunnel Fontan Patients

Camille L. Hancock Friesen, Megan C. Sherwood, Kimberley Gauvreau, Derk F. Frank, Pedro J. del Nido, Richard A. Jonas, John E. Mayer, Jr., Joseph M. Forbess
Departments of Cardiac Surgery, Cardiovascular Surgery and Cardiology, Children’s Hospital Boston, Departments of Pediatrics and Surgery, Harvard Medical School, Boston, MA, USA

Background and aim of the study: Lateral tunnel Fontan operation patients with atrioventricular valve (AVV) regurgitation have an increased incidence of Fontan failure (death, take-down or transplant). The outcomes of patients undergoing AVV repair during Fontan palliation were reviewed to determine the optimal technique and timing of repair.
Methods: Hospital records for all patients with AVV regurgitation at the time of their Fontan procedure were reviewed retrospectively. Patients with staged single-ventricle palliation culminating in a lateral tunnel Fontan operation who had their first AVV repair at the Children’s Hospital, Boston, were included. AVV regurgitation was graded by semi-quantitative color Doppler echocardiography on a scale of 1 to 4, as was ventricular dysfunction.
Results: Among 859 lateral tunnel Fontan patients, 27 (3%) had a total of 30 AVV repairs (18 tricuspid, six mitral, six common AVV). Of the 27 first-time AVV repairs (16 TV, six MV, five CAVV), six were performed

pre-Fontan, and 21 at or after Fontan. The median age at the first AVV repair was 3 years (range: 0.6-9.4 years). Preoperatively, the median echocardiographic severity of AVV regurgitation was grade 3 (range: 2-4). At median follow up of 1.2 years (range: 0-9.5 years) the severity of AVV regurgitation was reduced significantly to median grade 2 (range: 0-4; p <0.001). No patient with initial AVV repair at the time of Fontan underwent reoperation for AVV regurgitation. In all cases, ventricular function was maintained or improved, with preoperative median systemic ventricular function grade 1.5 (range: 1 to 4) versus postoperative grade 1 (range: 1-4; p = NS). There were no Fontan failures in the intermediate term.
Conclusion: AVV regurgitation and ventricular systolic function can be maintained or improved in the intermediate term following AVV repair in single-ventricle patients.
The Journal of Heart Valve Disease 2004;13:962-971

Intermediate Outcomes of Atrioventricular Valvuloplasty in Lateral Tunnel Fontan Patients

Click the above hyperlink to view the article, right click (Ctrl click on a Mac) to open in a new browser window or tab.

Purchase this Article

Please click the button below to purchase this article. Single article purchases are provided at $50.00 per article. Upon clicking the button below, single article user account subscription details are requested and, upon successful payment, a single article user account is created. Single articles are availble in your account for seven days after purchase.