Renewal of the Fontan circulation with concomitant surgical intervention for atrial arrhythmia.

Abstract

BACKGROUND:

Atrial arrhythmia remains one of the major complications in the longer term after the Fontan procedure.

METHODS:

Conversion to total cavopulmonary connection was carried out concomitantly with surgical intervention for atrial arrhythmia in 4 patients undergoing the Fontan procedure by atriopulmonary connection and having continual atrial fibrillation or flutter in the longer term after the initial procedure.

RESULTS:

The surgical intervention restored sinus rhythm. Transient atrial fibrillation occasionally occurred after the reoperation in 1 patient in whom duration of preoperative arrhythmic period had been 6 years, and defibrillation was needed twice. In the other 3 patients, no episodes of paroxysmal arrhythmia have been noted. Subsequent to renewal of the Fontan circulation, cardiac index increased, with systemic venous pressure decreasing. All 4 patients are currently doing well with their functional status of New York Heart Association functional class I.

CONCLUSIONS:

Combination of conversion to total cavopulmonary connection and concomitant surgical intervention for atrial arrhythmia is effective, when used appropriately and in a timely manner in patients with atrial arrhythmia in the longer term after the initial Fontan procedure by atriopulmonary connection.

• Authors: Y Kawahira, H Uemura, T Yagihara, Y Yoshikawa, S Kitamura
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 71 Issue 3 Pg. 919-21 (Mar 2001) ISSN: 0003-4975 [Print] Netherlands
• PMID: 11269474 (Publication Type: Journal Article)

Topics

• Arrhythmias, Cardiac (etiology, surgery)
• Fontan Procedure
• Heart Atria
• Humans