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  • Title: [Surgical outcomes of arrhythmia surgery associated with total cavo-pulmonary connection conversion for failed Fontan].
    Author: Hoashi T, Ueno T, Sawa Y.
    Journal: Kyobu Geka; 2010 Apr; 63(4):309-13. PubMed ID: 20387506.
    Abstract:
    BACKGROUND: The occurrence of late-onset supraventricular tachyarrhythmia is one of the major factors for Fontan failure. In 1999, we initiated the arrhythmia surgery with combined total cavo-pulmonary connection (TCPC) conversion for failed Fontan patients. PATIENTS AND METHODS: From 1999 to 2008, a total of 7 patients (5 males) underwent arrhythmia surgery with TCPC conversion for supraventricular tachyarrhythmia causing Fontan failure. Median age at operation and duration from last Fontan operation were 20.3 year-old (14.5-38.9) and 15.6 years (9.9-26.2), respectively. Previous Fontan procedure was atrio-pulmonary connection (APC) in 4 patients, lateral tunnel in 2, and right atrial-ventricular anastomosis (Bjork procedure) in 1. Right side maze procedure was applied for intraatrial reentrant tachycardia (IART) and full maze for atrial fibrillation (Afib). RESULTS: There ware no early death and 1 late death due to infectious endocarditis for median followup at 7.4 years (1.3-10.3). None of the patients showed recurrent or new onset IART or Afib, including the late expired case. Current New York Heart Association functional class was I in 4 patients and II in 2. CONCLUSIONS: TCPC conversion with arrhythmic surgery was successfully performed failed Fontan patients. All patients were converted to sinus rhythm and have kept it until now.
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