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Article Abstract
Objectives: In this study, we aimed to compare the outcome after the Fontan procedure in patients after an initial ductus stenting or a surgical aortopulmonary shunt.
Methods: We reviewed infants with single ventricle and ductal-dependent pulmonary blood flow who underwent ductus stenting or an aortopulmonary shunt between 2009 and 2022, and subsequently underwent the staged Fontan procedure.
Results: A total of 93 patients were included (39 ductus stenting and 54 aortopulmonary shunts). Before the Fontan procedure, pulmonary artery pressure (9 vs 9 mmHg, P = 0.376) and pulmonary artery index (184 vs 183 mm2/m2, P = 0.988) were similar between the groups. However, the incidence of venovenous collaterals was higher in patients after ductus stenting than those after aortopulmonary shunt (35.9 vs 16.7%, P = 0.034). Median age (1.9 vs 1.8 years, P = 0.493) and weight at the Fontan procedure (12 vs 11 kg, P = 0.596) were similar between the groups. There was no in-hospital mortality in each group. The length of the intensive care unit stay (median 5 vs 5 days, P = 0.542) and hospital stay (median 17 vs 14 days, P = 0.767) were similar between the groups. During the median follow-up of 2.5 years, one late death was observed in the ductal stenting group. Freedom from reintervention (66.6 vs 82.0%, P = 0.095) and from adverse events (78.6 vs 92.2%, P = 0.488) at 5 years were similar between the groups.
Conclusions: This pilot study demonstrated comparable outcomes following the Fontan procedures between patients with single ventricle and ductal-dependent pulmonary blood flow after initial ductus stenting and those after initial aortopulmonary shunt.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145171 | PMC |
| http://dx.doi.org/10.1093/icvts/ivaf118 | DOI Listing |
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