Early outcomes after extracardiac conduit fontan operation without cardiopulmonary bypass

Amy McCammond, Kevin Kuo, Victoria N. Parikh, Kameelah Abdullah, Raymond Balise, Frank L. Hanley, Stephen J. Roth

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Cardiopulmonary bypass is associated with a systemic inflammatory response. The authors hypothesized that avoiding cardiopulmonary bypass would lead to improved postoperative outcomes for patients undergoing the extracardiac Fontan operation, the final stage in surgical palliation of univentricular congenital heart defects.A review of the Children's Heart Center Database showed a total of 73 patients who underwent an initial Fontan operation at Lucile Packard Children's Hospital at Stanford between 1 November 2001 and 1 November 2006. These patients were divided into two groups: those who underwent cardiopulmonary bypass (n = 26) and those who avoided cardiopulmonary bypass (n = 47). Preoperative demographics, hemodynamics, and early postoperative outcomes were analyzed. The two groups had comparable preoperative demographic characteristics and hemodynamics except that the average weight of the off-bypass group was greater (17.9 ± 9.1 vs 14.2 ± 2.7 kg; P = 0.01). Intraoperatively, the off-bypass group trended toward a lower rate of Fontan fenestration (4.3 vs 19.2%; P = 0.09), had lower common atrial pressures (4.6 ± 1.4 vs 5.5 ± 1.5 mmHg; P = 0.05), and Fontan pressures (11.9 ± 2.1 vs 14.2 ± 2.4 mmHg; P ≤ 0.01), and required less blood product (59.1 ± 37.6 vs 91.9 ± 49.4 ml/ kg; P ≤ 0.01). Postoperatively, there were no significant differences in hemodynamic parameters, postoperative colloid requirements, duration of mechanical ventilation, volume or duration of pleural drainage, or duration of cardiovascular intensive care unit or hospital stay. Avoiding cardiopulmonary bypass influenced intraoperative hemodynamics and the incidence of fenestration but did not have a significant impact on the early postoperative outcomes of children undergoing the Fontan procedure.

Original languageEnglish (US)
Pages (from-to)1078-1085
Number of pages8
JournalPediatric Cardiology
Volume33
Issue number7
DOIs
StatePublished - Oct 2012

Fingerprint

Fontan Procedure
Cardiopulmonary Bypass
Hemodynamics
Demography
Atrial Pressure
Congenital Heart Defects
Colloids
Artificial Respiration
Intensive Care Units
Drainage
Length of Stay
Databases
Pressure
Weights and Measures
Incidence

Keywords

  • Cardiopulmonary bypass
  • CHD-Fontan
  • Complications and management
  • CPB
  • Inflammatory response
  • Off-pump surgery
  • Outcomes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

McCammond, A., Kuo, K., Parikh, V. N., Abdullah, K., Balise, R., Hanley, F. L., & Roth, S. J. (2012). Early outcomes after extracardiac conduit fontan operation without cardiopulmonary bypass. Pediatric Cardiology, 33(7), 1078-1085. https://doi.org/10.1007/s00246-012-0228-5

Early outcomes after extracardiac conduit fontan operation without cardiopulmonary bypass. / McCammond, Amy; Kuo, Kevin; Parikh, Victoria N.; Abdullah, Kameelah; Balise, Raymond; Hanley, Frank L.; Roth, Stephen J.

In: Pediatric Cardiology, Vol. 33, No. 7, 10.2012, p. 1078-1085.

Research output: Contribution to journalArticle

McCammond, A, Kuo, K, Parikh, VN, Abdullah, K, Balise, R, Hanley, FL & Roth, SJ 2012, 'Early outcomes after extracardiac conduit fontan operation without cardiopulmonary bypass', Pediatric Cardiology, vol. 33, no. 7, pp. 1078-1085. https://doi.org/10.1007/s00246-012-0228-5
McCammond A, Kuo K, Parikh VN, Abdullah K, Balise R, Hanley FL et al. Early outcomes after extracardiac conduit fontan operation without cardiopulmonary bypass. Pediatric Cardiology. 2012 Oct;33(7):1078-1085. https://doi.org/10.1007/s00246-012-0228-5
McCammond, Amy ; Kuo, Kevin ; Parikh, Victoria N. ; Abdullah, Kameelah ; Balise, Raymond ; Hanley, Frank L. ; Roth, Stephen J. / Early outcomes after extracardiac conduit fontan operation without cardiopulmonary bypass. In: Pediatric Cardiology. 2012 ; Vol. 33, No. 7. pp. 1078-1085.
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