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Clinical Outcome of 193 Extracardiac Fontan Patients

The First 15 Years

Salvatore Giannico, MD^_*,_*, Fatma Hammad, MD, Antonio Amodeo, MD^_*, Guido Michielon, MD^_*, Fabrizio Drago, MD^_*, Attilio Turchetta, MD, Roberto Di Donato, MD^_* and Stephen P. Sanders, MD, FACC^_*

^_* Departments of Pediatric Cardiology and Cardiac Surgery
Pediatrics, Bambino Ges Hospital, Rome, Italy

View larger version (15K): [in a new window]   Figure 1 Outcome of 193 survivors. Thirty-six patients experienced 42 late complications: 6 patients with 2 complications are indicated with asterisks. One patient with sinus dysfunction and left pulmonary artery (LPA) stenosis. One patient with conduit stenosis and LPA stenosis. One patient with ventricular failure and conduit stenosis. *One patient with ventricular failure and atrial arrhythmias. #One patient with ventricular failure and LPA stenosis. °One patient with atrioventricular block (AVB) and LPA stenosis. AVR = aortic valve replacement; HT = heart transplantation; PBA = percutaneous balloon angioplasty; PMK = pacemaker.

View larger version (8K): [in a new window]   Figure 2 Kaplan-Meier estimates of the probability of freedom from late Fontan failure (probability of survival with an intact Fontan circulation; time zero is discharge from the hospital or the 30th day after surgery). Patients who did not experience a late failure of the Fontan circulation (death, takedown, or heart transplantation) were censored at the time of the last follow-up.

View larger version (8K): [in a new window]   Figure 3 Kaplan-Meier estimates of the probability of freedom from cavopulmonary pathway obstructions and catheter-based re-intervention. Time zero in this and subsequent graphs is 30 days after extracardiac Fontan procedure.

View larger version (8K): [in a new window]   Figure 4 The Kaplan-Meier estimates of the probability of freedom from arrhythmia.

View larger version (8K): [in a new window]   Figure 5 The Kaplan-Meier estimates of the probability of freedom from all re-interventions.

View larger version (8K): [in a new window]   Figure 6 The Kaplan-Meier estimates of the probability of freedom from pacemaker implantation.