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Fontan completion during winter season is not associated with higher mortality or morbidity in the early post-operative period

Published online by Cambridge University Press:  13 April 2020

Sarah Nordmeyer Open the ORCID record for Sarah Nordmeyer [Opens in a new window] ,
Sabeth Krettek ,
Johannes Nordmeyer ,
Marie Schafstedde ,
Konstantin Rehm ,
Joachim Photiadis ,
Felix Berger  and
Stanislav Ovroutski
Sarah Nordmeyer*
Affiliation:
German Heart Center Berlin, Department of Congenital Heart Disease – Pediatric Cardiology, Berlin, Germany
Sabeth Krettek
Affiliation:
German Heart Center Berlin, Department of Congenital Heart Disease – Pediatric Cardiology, Berlin, Germany
Johannes Nordmeyer
Affiliation:
German Heart Center Berlin, Department of Congenital Heart Disease – Pediatric Cardiology, Berlin, Germany
Marie Schafstedde
Affiliation:
German Heart Center Berlin, Department of Congenital Heart Disease – Pediatric Cardiology, Berlin, Germany
Konstantin Rehm
Affiliation:
German Heart Center Berlin, Department of Congenital Heart Disease – Pediatric Cardiology, Berlin, Germany
Joachim Photiadis
Affiliation:
German Heart Center Berlin, Department of Congenital Heart Surgery – Pediatric Heart Surgery, Berlin, Germany
Felix Berger
Affiliation:
German Heart Center Berlin, Department of Congenital Heart Disease – Pediatric Cardiology, Berlin, Germany
Stanislav Ovroutski
Affiliation:
German Heart Center Berlin, Department of Congenital Heart Disease – Pediatric Cardiology, Berlin, Germany
*
Address for correspondence: S. Nordmeyer, MD, German Heart Center Berlin, Department of Congenital Heart Disease – Pediatric Cardiology, Augustenburger Platz 1, 13353Berlin, Germany. Tel: +49 30 4593 2800; Fax: +49 30 4593 2900. E-mail: snordmeyer@dhzb.de
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Abstract

Objectives:

The aim of our study was to compare post-operative outcome after total cavopulmonary connection between patients operated during winter and summer season.

Methods:

We retrospectively studied 211 patients who underwent extracardiac total cavopulmonary connection completion at our institution between 1995 and 2015 (median age 4 (1–42) years). Seventy (33%) patients were operated during winter (November to March) and 141 (67%) patients during summer season (April to October).

Results:

Patients operated during winter and summer season showed no difference in early mortality (7% versus 5%, p = 0.52) and severe morbidity like need for early Fontan takedown (1% versus 1%, p = 0.99) and need for mechanical circulatory support (9% versus 4%, p = 0.12). The post-operative course and haemodynamic outcome were comparable between both groups of patients (ICU (4 versus 3 days, p = 0.44) and hospital stay (15 versus 14 days, p = 0.28), prolonged pleural effusions (36% versus 31%, p = 0.51), need for dialysis (16% versus 11%, p = 0.37), ascites (37% versus 33%, p = 0.52), supraventricular tachyarrhythmia (16% versus 13%, p = 0.56) and chylothorax (26% versus 16%, p = 0.12), change of antibiotic treatment (47% versus 36%, p = 0.06), prolonged inotropic support (24% versus 14%, p = 0.05), intubation time (15 versus 12 hours, p = 0.33), and incidence of fast-track extubation (11% versus 22%, p = 0.06).

Conclusion:

Outcomes after total cavopulmonary connection completion during winter and summer season were comparably related to mortality, severe morbidity, or longer hospital stay in the early post-operative period. These results suggest that total cavopulmonary connection completion during winter season is as safe as during summer season.

Keywords

Total cavopulmonary connectionwinter seasonearly post-operative outcome
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 5 , May 2020 , pp. 629 - 632
Copyright
© The Author(s) 2020. Published by Cambridge University Press

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