关键词: Arrhythmia Congenital heart disease Exercise capacity Fontan operation Fontan physiology Late outcomes Single ventricle physiology

Mesh : Adult Exercise Tolerance Fontan Procedure / adverse effects methods mortality Heart Defects, Congenital / classification surgery Humans Postoperative Complications / physiopathology surgery Prognosis Reoperation / methods

来  源:   DOI:10.1016/j.ccl.2020.05.002   PDF(Sci-hub)

Abstract:
The authors summarize the most important anatomic and physiologic substrates of Fontan circulation. Common anatomic substrates include hypoplastic left heart syndrome, tricuspid atresia, double inlet left ventricle, and unbalanced atrioventricular septal defects. After the Fontan operation exercise capacity is limited and the key hemodynamic drivers is limited preload due to a relatively fixed pulmonary vascular resistance. The authors provide contemporary data on survival, morbidity, and need for reintervention. Operative morality is now expected to be less than 1% and 30 year survival approximately 89%. The authors delineate potential therapeutic approaches for the potential late complications.
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