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Extracardiac conduit fontan for children with heterotaxy and functionally single ventricle

Published online by Cambridge University Press:  19 August 2008

Richard D. Mainwaring*
Affiliation:
Cardiac Institute, Children’s Hospital and Health Center, San Diego, CA, USA
John J. Lamberti
Affiliation:
Cardiac Institute, Children’s Hospital and Health Center, San Diego, CA, USA
*
Richard D. Mainwaring, M.D., The Nemours Cardiac Center, A.I. Dupont Hospital For Children, 1600 Rockland Road, P.O. Box 269, Wilmington, Delaware 19899, USA. Fax: (302) 651-5345

Abstract

Children with functionally single ventricle in the setting of visceral heterotaxy (isomerism) may present a surgical challenge at the time of Fontan completion because of anomalies of systemic and pulmonary venous drainage. We have used an extracardiac conduit in this population to direct inferior caval venous blood to the pulmonary arteries.

Over the past five years, nine children with heterotaxy and a functionally single ventricle underwent correction by placement of an extracardiac synthetic (Gore-Tex) conduit. All patients had previously undergone a bidirectional Glenn procedure. Age and weight at the time of insertion of the extracardiac conduit were 26±15 months, and 11±2 kilograms, respectively.

Results

Of the nine children, six had an uneventful recovery. One developed elevated venous pressures and required a ’fenestration procedure’. Two patients developed pleural effusions. Median length of stay in hospital was 10 days. All children are alive and well, with follow-up of 19±16 months. There have been no thromboembolic complications.

Conclusions

The extracardiac conduit has worked well in our experience for the completion of the Fontan circulation in children with functionally single ventricle in the setting of visceral heterotaxy.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1998

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References

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