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Cardiopulmonary function in adult patients late after Fontan repair.

Cardiopulmonary function in adult patients late after Fontan repair.

Authors :
Harrison DA
Liu P
Walters JE
Goodman JM
Siu SC
Webb GD
Williams WG
McLaughlin PR
Source :
Journal of the American College of Cardiology [J Am Coll Cardiol] 1995 Oct; Vol. 26 (4), pp. 1016-21.
Publication Year :
1995

Abstract

Objectives: The clinical status and exercise assessment of adult patients late after the Fontan operation were reviewed to determine cardiovascular function.<br />Background: The Fontan operation is the final operation for many patients with tricuspid atresia or a single ventricle. Follow-up reports describe most patients to be in Canadian Cardiovascular Society functional class I or II. Objective measures of cardiac performance in the pediatric age group have shown significant dysfunction.<br />Methods: Forty-seven adult patients were seen late after the Fontan operation at the Toronto Congenital Cardiac Centre for Adults. Thirty of these underwent cycle ergometry to determine maximal exercise capacity. Maximal ventilation, maximal oxygen uptake and anaerobic threshold were determined from a ramp exercise protocol. Ejection fraction at rest and during exercise was measured with gated radionuclide angiography. Results were compared with those of eight normal volunteers. Results are given as mean +/- SD.<br />Results: Thirty patients underwent cardiopulmonary exercise testing 6.7 +/- 3.9 years after a first Fontan operation. Clinically 93% were in functional class I or II. The Fontan group patients had a significantly lower maximal work load (548 +/- 171 vs. 1,094 +/- 190 kilopond-meters, p < 0.00001), anaerobic threshold (11.2 +/- 2.9 vs. 23.6 +/- 4.6 ml/kg per min) and maximal oxygen consumption (14.8 +/- 4.5 vs. 42.1 +/- 10.0 ml/kg per min). Systemic ventricular ejection fraction was lower at rest (38 +/- 12% vs. 58 +/- 7%) and during exercise (40 +/- 15% vs. 70 +/- 8%).<br />Conclusions: Despite a clinical impression of good function, by objective measures adult patients continue to have significant cardiovascular limitation late after the Fontan operation.

Details

Language :
English
ISSN :
0735-1097
Volume :
26
Issue :
4
Database :
MEDLINE
Journal :
Journal of the American College of Cardiology
Publication Type :
Academic Journal
Accession number :
7560594
Full Text :
https://doi.org/10.1016/0735-1097(95)00242-7