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Fontan Operation Experience and Results of Our Cardiovascular Surgery

Farid Gojayev*, Emin Tireli

Objective: In this study, we present our experiences and results of the first Fontan surgeries we performed in our center in accordance with the surgical criteria we believe in.

Materials and methods: This is an observational study involving 19 patients. We investigated the data and survival rate of 19 patients who underwent Fontan surgery one by one. We wanted to know how the surgical method we used and the age factor affected our results. Our main hypothesis was to keep the cardiopulmonary bypass time very short and not to prefer the total circulatory arrest method.

Results: Patients were not homogeneous in terms of demographic characteristics. Patients differed in terms of pre and postoperative cardiac diagnosis and complications. We lost 2 of 19 patients and the overall mortality rate was 10.5%. We used Extra Cardiac Membrane Oxygenation (ECMO) support in 3 patients. We applied ICD implantation to the patient. The discharge due to effusion due to chylothorax was prolonged in 4 patients. The postoperative NHYA capacity of the patients was evaluated as 1 or 2.

Discussion: We recommend that this operation should not be performed at a very young age, if the oxygen saturation value of heart patients who are candidates for Fontan is not very critical, if the ventricular ejection fraction capacity is not low, if the physical exertion capacity and examination findings are within normal limits.

Conclusion: The Fontan procedure is still the best long-term palliative operation for all single ventricle cases. We believe that it would be beneficial to postpone this surgery to the advanced age group as much as possible in order not to increase the mortality rate.