Noninvasive evaluations of pulmonary circulation, cardiac function, and liver excreting rate at late follow-up following the modified Fontan operation

Tomio Abe; Masayuki Morikawa; Sakuzo Komatsu; Kazuo Morita; Masahiro Kubota; Takatoshi Tsuda

doi:10.1007/BF01616276

International Journal of Angiology, Table of Contents

Int J Angiol 1998; 7(1): 46-51
DOI: 10.1007/BF01616276

Original Articles

Noninvasive evaluations of pulmonary circulation, cardiac function, and liver excreting rate at late follow-up following the modified Fontan operation

Tomio Abe¹ , Masayuki Morikawa¹ , Sakuzo Komatsu¹ , Kazuo Morita² , Masahiro Kubota² , Takatoshi Tsuda²

¹Department of Thoracic & Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
²Department of Radiology, Sapporo Medical University School of Medicine, Sapporo, Japan

Presented at the 36th Annual World Congress, International College of Angiology, New York, New York, July 1994.

Abstract

PDF Download

Abstract

The purpose of this paper was to define the late postoperative pulmonary circulation and cardiac and liver functions after a modified Fontan operation by radionuclide studies. Eleven patients (5 with single ventricle and 6 with double outlet right ventricle) underwent a modified Fontan operation using a RA-PA anastomosis. These 11 patients ranging in age from 7 to 42 years (mean 17 ± 10 years) were examined at 4.7–12.1 years (mean 8.6 ± 2.4 years) postoperatively and compared with studies in 10 normal adults. Pulmonary circulation, cardiac function and liver excreting function were determined by intravenous administration of Tc-MAA, Tc-PYP, and Tc-PMT, respectively. No extrapulmonary radioactivity was detected by Tc-MAA lung perfusion in patients. Although the cardiac diastolic function of the patients remained normal, the systolic functions (EF = 46.4 ± 7.8%, 1/3EF = 11.2 ± 4.4%, PER = 1.93 ± 0.54/sec) of the patients were significantly decreased compared with those of normal controls (EF = 54.7 ± 4.7%, 1/3EF = 21.7 ± 2.1%, PER = 2.91 ± 0.4/sec), respectively. The mean level of MTT of the patients (9.4 ± 2.7 minutes) was also significantly prolonged compared with that of normal controls (6.1 ± 4.4 minutes). Some of these deteriorated parameters clearly related to higher age at operation and length of intervals since operation. These data suggest that the earlier surgical intervention by the Fontan operation is desired for the complex congenital cardiac anomalies.

PDF (744 kb)