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Fontan surgery failure: risk factors and experience in a Colombian reference centre

Published online by Cambridge University Press:  25 September 2023

Isabel C. Sánchez-Escobar Open the ORCID record for Isabel C. Sánchez-Escobar [Opens in a new window] ,
Andrés D. Aranzazu-Ceballos Open the ORCID record for Andrés D. Aranzazu-Ceballos [Opens in a new window] ,
Luz E. Pérez Open the ORCID record for Luz E. Pérez [Opens in a new window]  and
Mónica I. Guzmán Open the ORCID record for Mónica I. Guzmán [Opens in a new window]
Isabel C. Sánchez-Escobar*
Affiliation:
Fellow Pediatric Cardiology, CardioVid Clinic, Pontifical Bolivarian University, Medellin, Colombia
Andrés D. Aranzazu-Ceballos
Affiliation:
Pediatrician, Faculty of Medicine, CardioVid Clinic, Universidad Pontificia Bolivariana, Medellin, Colombia
Luz E. Pérez
Affiliation:
Medical Epidemiologist, CardioVid Clinic, Medellin, Colombia
Mónica I. Guzmán
Affiliation:
Pediatric Cardiologist, CardioVid Clinic, Medellin, Colombia
*
Corresponding author: I. C. Sánchez-Escobar; Email: isasanchez36@gmail.com
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Abstract

Background:

The Fontan procedure is considered one of the most remarkable achievements in paediatric cardiology and cardiac surgery. Its final anatomical objective is a venous return through the superior and inferior vena cava. The complications inherent to this procedure and subsequent failure are its limitations.

Objective:

To describe the clinical and haemodynamic characteristics of patients with Fontan failure and define the risk factors associated with it, with its short- and long-term outcomes during a 21-year observation period.

Methods:

This is a retrospective follow-up study in which 15 patients diagnosed with Fontan failure in the single-ventricle programme of a high-complexity hospital in Medellín, Colombia, between 2001 and 2022 were included.

Results:

One hundred and eight patients were identified in whom the Fontan procedure was performed, and 17 met the failure criteria. 82.4% were men, with a median age of 4.3 years. Ebstein’s anomaly was the most common diagnosis, 29.4%. All patients underwent Fontan with an extracardiac tube following the procedure. According to the type of failure, 58.8% of patients presented protein-losing enteropathy and 17.6% plastic bronchitis. During follow-up, 5.9% of patients died.

Conclusion:

Fontan surgery in our centre is an option for patients with univentricular physiology. The correct selection of the patient is essential to mitigate failure risks.

Keywords

Fontan techniqueuniventricular heartprotein-losing enteropathiesCHD
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 4 , April 2024 , pp. 722 - 726
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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