Percutaneous interventions in Fontan circulation
Introduction and objectives: Different percutaneous interventional procedures are needed to reach and maintain adequate anatomical and physiological conditions for the Fontan circulation. We aim to describe the experience gained at a children's hospital in such interventions, and to analyze the...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2015-09-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906715300117 |
| _version_ | 1824043077390565376 |
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| author | Eduardo Franco Enrique José Balbacid Domingo Viviana Arreo del Val Luis Garcia Guereta Silva María Jesús del Cerro Marín Aurora Fernández Ruiz Fernando Villagrá Federico Gutiérrez-Larraya Aguado |
| author_facet | Eduardo Franco Enrique José Balbacid Domingo Viviana Arreo del Val Luis Garcia Guereta Silva María Jesús del Cerro Marín Aurora Fernández Ruiz Fernando Villagrá Federico Gutiérrez-Larraya Aguado |
| author_sort | Eduardo Franco |
| collection | DOAJ |
| description | Introduction and objectives: Different percutaneous interventional procedures are needed to reach and maintain adequate anatomical and physiological conditions for the Fontan circulation. We aim to describe the experience gained at a children's hospital in such interventions, and to analyze the clinical outcomes.
Methods: Retrospective study of all patients with Fontan circulation completed between 1995 and 2013. We analyzed the clinical characteristics and the different types of percutaneous interventions performed, considering three different periods of time: before Glenn surgery, between Glenn and Fontan surgeries, and after Fontan was completed. Survival and time to indication of percutaneous interventions in each period were analyzed, as well as the clinical situation at last follow-up.
Results: Of the 91 patients analyzed, 46 (50.5%) required percutaneous interventions. The most frequent procedures were pulmonary artery angioplasty and angioplasty of the Fontan conduit. Estimated survival at 10, 20 and 30 years of age was 96.2%, 94.7% and 89.4%, respectively. There were no significant differences in survival of patients undergoing percutaneous interventions or not. Overall survival and time to indication of percutaneous interventions were significantly lower in the group of patients with right morphology systemic ventricle. Patients with fenestrated Fontan required interventions more frequently. At the end of follow-up, 66 patients (72.5%) were asymptomatic, without significant differences between patients who underwent or did not undergo percutaneous interventions.
Conclusions: Interventional catheterization procedures are often necessary to reach and maintain the fragile Fontan circulation, mainly in patients with right morphology systemic ventricles and fenestrated Fontan conduits. |
| first_indexed | 2024-12-22T23:51:11Z |
| format | Article |
| id | doaj.art-a540d079d760411d8e7efd2b5d66abe1 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-12-22T23:51:11Z |
| publishDate | 2015-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-a540d079d760411d8e7efd2b5d66abe12022-12-21T18:08:07ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672015-09-018C13814610.1016/j.ijcha.2015.06.008Percutaneous interventions in Fontan circulationEduardo Franco0Enrique José Balbacid Domingo1Viviana Arreo del Val2Luis Garcia Guereta Silva3María Jesús del Cerro Marín4Aurora Fernández Ruiz5Fernando Villagrá6Federico Gutiérrez-Larraya Aguado7Electrophysiology Unit, Cardiology Department, Ramón y Cajal Hospital, Madrid, SpainPediatric Cardiology Department, La Paz Children's University Hospital, Madrid, SpainPediatric Cardiology Department, La Paz Children's University Hospital, Madrid, SpainPediatric Cardiology Department, La Paz Children's University Hospital, Madrid, SpainPediatric Cardiology Department, Ramón y Cajal Hospital, Madrid, SpainPediatric Cardiology Department, Ramón y Cajal Hospital, Madrid, SpainPediatric Cardiology Department, Ramón y Cajal Hospital, Madrid, SpainPediatric Cardiology Department, Ramón y Cajal Hospital, Madrid, SpainIntroduction and objectives: Different percutaneous interventional procedures are needed to reach and maintain adequate anatomical and physiological conditions for the Fontan circulation. We aim to describe the experience gained at a children's hospital in such interventions, and to analyze the clinical outcomes. Methods: Retrospective study of all patients with Fontan circulation completed between 1995 and 2013. We analyzed the clinical characteristics and the different types of percutaneous interventions performed, considering three different periods of time: before Glenn surgery, between Glenn and Fontan surgeries, and after Fontan was completed. Survival and time to indication of percutaneous interventions in each period were analyzed, as well as the clinical situation at last follow-up. Results: Of the 91 patients analyzed, 46 (50.5%) required percutaneous interventions. The most frequent procedures were pulmonary artery angioplasty and angioplasty of the Fontan conduit. Estimated survival at 10, 20 and 30 years of age was 96.2%, 94.7% and 89.4%, respectively. There were no significant differences in survival of patients undergoing percutaneous interventions or not. Overall survival and time to indication of percutaneous interventions were significantly lower in the group of patients with right morphology systemic ventricle. Patients with fenestrated Fontan required interventions more frequently. At the end of follow-up, 66 patients (72.5%) were asymptomatic, without significant differences between patients who underwent or did not undergo percutaneous interventions. Conclusions: Interventional catheterization procedures are often necessary to reach and maintain the fragile Fontan circulation, mainly in patients with right morphology systemic ventricles and fenestrated Fontan conduits.http://www.sciencedirect.com/science/article/pii/S2352906715300117Fontan procedurePercutaneous interventionCongenital heart diseaseCardiac catheterization |
| spellingShingle | Eduardo Franco Enrique José Balbacid Domingo Viviana Arreo del Val Luis Garcia Guereta Silva María Jesús del Cerro Marín Aurora Fernández Ruiz Fernando Villagrá Federico Gutiérrez-Larraya Aguado Percutaneous interventions in Fontan circulation International Journal of Cardiology: Heart & Vasculature Fontan procedure Percutaneous intervention Congenital heart disease Cardiac catheterization |
| title | Percutaneous interventions in Fontan circulation |
| title_full | Percutaneous interventions in Fontan circulation |
| title_fullStr | Percutaneous interventions in Fontan circulation |
| title_full_unstemmed | Percutaneous interventions in Fontan circulation |
| title_short | Percutaneous interventions in Fontan circulation |
| title_sort | percutaneous interventions in fontan circulation |
| topic | Fontan procedure Percutaneous intervention Congenital heart disease Cardiac catheterization |
| url | http://www.sciencedirect.com/science/article/pii/S2352906715300117 |
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