Abstract
BACKGROUND AND AIM: The first Fontan procedure performed in the Children’s clinical university hospital in Riga was commenced in 2012. Since then, the perioperative care and surgical skills have improved significantly, although in a population of 1,8 million it is a challenge to keep good quality with a low volume of Fontan procedures.
METHODS: We reviewed the medical records of all the patients undergoing a Fontan procedure between 2012 and 2021 that was performed in the Children's Clinical University Hospital in Latvia.
RESULTS: Between 2012 and 2021, a total of 19 patients underwent Fontan procedure in our hospital. Since November 2020 we have performed the Fontan procedure without the assistance of a mentor surgeon from a more experienced center. At the time of surgery, the mean age was 6.1 ± 2.0 (4-12) years. The mean weight at the time of surgery was 18.3 ± 3.9 (12-25) kg. Mean pulmonary artery pressure before the surgery was 9.3 ± 3.5 (4-17) mmHg. For three patients the main ventricle was the right ventricle, for 14 patients – the left ventricle, and for two patients both ventricles. Aortic occlusion was necessary for 5 patients to perform additional surgical interventions besides the Fontan procedure. Four patients did not have Fontan tunnel fenestration for several reasons. The mean cardiopulmonary bypass time was 142 minutes. 11 out of 19 patients were extubated in the operating theatre. The mean time for chest drains removal was 7.2 ± 2.8 (3–15) postoperative day (POD). For those extubated in the operating theatre, drains were removed significantly earlier (before POD7) compared with those extubated later (p 0.02). The mean length of stay in the intensive care unit was 7.1 ± 2.8 (3–16) days.
CONCLUSIONS: Completing the Fontan surgery in a country with a small population is feasible with acceptable results. Since 2018 most of the patients underwent fast-track extubation which has resulted in an earlier chest drain removal time.
Keywords: Fontan
METHODS: We reviewed the medical records of all the patients undergoing a Fontan procedure between 2012 and 2021 that was performed in the Children's Clinical University Hospital in Latvia.
RESULTS: Between 2012 and 2021, a total of 19 patients underwent Fontan procedure in our hospital. Since November 2020 we have performed the Fontan procedure without the assistance of a mentor surgeon from a more experienced center. At the time of surgery, the mean age was 6.1 ± 2.0 (4-12) years. The mean weight at the time of surgery was 18.3 ± 3.9 (12-25) kg. Mean pulmonary artery pressure before the surgery was 9.3 ± 3.5 (4-17) mmHg. For three patients the main ventricle was the right ventricle, for 14 patients – the left ventricle, and for two patients both ventricles. Aortic occlusion was necessary for 5 patients to perform additional surgical interventions besides the Fontan procedure. Four patients did not have Fontan tunnel fenestration for several reasons. The mean cardiopulmonary bypass time was 142 minutes. 11 out of 19 patients were extubated in the operating theatre. The mean time for chest drains removal was 7.2 ± 2.8 (3–15) postoperative day (POD). For those extubated in the operating theatre, drains were removed significantly earlier (before POD7) compared with those extubated later (p 0.02). The mean length of stay in the intensive care unit was 7.1 ± 2.8 (3–16) days.
CONCLUSIONS: Completing the Fontan surgery in a country with a small population is feasible with acceptable results. Since 2018 most of the patients underwent fast-track extubation which has resulted in an earlier chest drain removal time.
Keywords: Fontan
| Original language | English |
|---|---|
| Pages | 619 |
| Number of pages | 1 |
| Publication status | Published - 25 May 2022 |
| Event | 55th Annual Meeting of the Association for European Pediatric and Congenital Cardiology (AEPC) - Geneva, Switzerland Duration: 25 May 2022 → 28 May 2022 Conference number: 55 https://www.aepc.org/aepc-annual-meeting https://conferencealerts.com/show-event?id=240395 |
Meeting
| Meeting | 55th Annual Meeting of the Association for European Pediatric and Congenital Cardiology (AEPC) |
|---|---|
| Abbreviated title | AEPC 2022 |
| Country/Territory | Switzerland |
| City | Geneva |
| Period | 25/05/22 → 28/05/22 |
| Internet address |
Keywords*
- Fontan
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)