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Titolo:
Clinical outcome of fenestrated Fontan patients after closure - The first 10 years
Autore:
Goff, DA; Blume, ED; Gauvreau, K; Mayer, JE; Lock, JE; Jenkins, KJ;
Indirizzi:
Boston Childrens Hosp, Dept Cardiol, Boston, MA 02115 USA Boston ChildrensHosp Boston MA USA 02115 t Cardiol, Boston, MA 02115 USA Boston Childrens Hosp, Dept Cardiac Surg, Boston, MA 02115 USA Boston Childrens Hosp Boston MA USA 02115 diac Surg, Boston, MA 02115 USA Harvard Univ, Sch Med, Dept Pediat, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 h Med, Dept Pediat, Boston, MA 02115 USA Harvard Univ, Sch Med, Dept Surg, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 Sch Med, Dept Surg, Boston, MA 02115 USA
Titolo Testata:
CIRCULATION
fascicolo: 17, volume: 102, anno: 2000,
pagine: 2094 - 2099
SICI:
0009-7322(20001024)102:17<2094:COOFFP>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
BAFFLE FENESTRATION; TRICUSPID ATRESIA; INTERATRIAL COMMUNICATION; OXYGEN DELIVERY; RISK-FACTORS; OPERATION; OCCLUSION; CHILDREN; OCCLUDER;
Keywords:
Fontan procedure; outcome; fenestration;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Jenkins, KJ Boston Childrens Hosp, Dept Cardiol, 300 Longwood Ave, Boston,MA 02115 USA Boston Childrens Hosp 300 Longwood Ave Boston MA USA 02115 USA
Citazione:
D.A. Goff et al., "Clinical outcome of fenestrated Fontan patients after closure - The first 10 years", CIRCULATION, 102(17), 2000, pp. 2094-2099

Abstract

Background-The late clinical status of Fontan patients after fenestration closure is unknown. Data are now available on all patients who underwent closure from 1989 to 1999. Methods and Results-All patients who underwent catheter closure of a Fontan fenestration were enrolled in either the Clamshell (1989 to 1994) or CardioSEAL (1996 to 1999) regulatory trials. Physiological values obtained at catheterization helped assess the hemodynamic effects of fenestration occlusion. Tn addition to survival, outcomes assessed included O-2 saturations, medication use, significant clinical findings leg, heart failure, protein-losing enteropathy, or new arrhythmias), and somatic growth. Of 181 patients who underwent closure, 27 had additional significant leaks. The remaining 154 patients constituted the study group. Median time from closure to latestfollow-up was 3.4 years (range 0.4 to 10.3 years). Fenestration closure increased O-2 saturation 9.4% on average (P<0.001). The numbers of patients receiving digoxin or diuretics decreased at the most recent follow-up compared with baseline (P<0.001), but use of antiarrhythmic agents increased marginally (P=0.05). Height and weight percentiles rose (medians of 2 and 4, respectively; P<0.001), Clinical decompensation during follow-up of 154 patients was rare (4.5%), with 2 deaths, 3 Fontan revisions, and 1 patient each with protein-losing enteropathy and ascites, No other patient developed chronic congestive symptoms: 21 patients developed new arrhythmias, and 2 had a stroke or transient ischemic attack. Conclusions-Fenestration closure in Fontan patients was followed by improved oxygenation, reduced need for anticongestive medication, and improved somatic growth at latest follow-up. Death (1.3%) or chronic decompensation (3.2%) was rare.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/09/20 alle ore 11:32:24