Hemodynamic Characteristics After Fontan Procedure in Patients with Down’s Syndrome
Patients with Down’s syndrome (DS) are generally regarded as not being good candidates for the Fontan procedure. However, detailed hemodynamic changes over time are not fully clarified. A retrospective chart review of all patients with DS who underwent the Fontan procedure and 5 times that number of...
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| Published in: | Pediatric cardiology Vol. 43; no. 2; pp. 360 - 365 |
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| Abstract | Patients with Down’s syndrome (DS) are generally regarded as not being good candidates for the Fontan procedure. However, detailed hemodynamic changes over time are not fully clarified. A retrospective chart review of all patients with DS who underwent the Fontan procedure and 5 times that number of Fontan patients without DS performed in Fukuoka Children’s Hospital and Kyushu University Hospital. Seven Fontan patients with DS were identified, and 35 Fontan patients without DS were recruited. During the mean observational periods of 14.7 years and 15.0 years (DS and non-DS, respectively) after the Fontan procedure, only one DS patient died. Central venous pressure (CVP) and transpulmonary pressure gradient significantly increased, and arterial oxygen saturation significantly decreased over time in DS patients after the Fontan procedure compared with those without DS. CVP in DS patients after the Fontan procedure increased over time compared with non-DS patients. Better management including the efficacy of Pulmonary arterial hypertension-specific therapy should be clarified in further studies. |
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| AbstractList | Patients with Down’s syndrome (DS) are generally regarded as not being good candidates for the Fontan procedure. However, detailed hemodynamic changes over time are not fully clarified. A retrospective chart review of all patients with DS who underwent the Fontan procedure and 5 times that number of Fontan patients without DS performed in Fukuoka Children’s Hospital and Kyushu University Hospital. Seven Fontan patients with DS were identified, and 35 Fontan patients without DS were recruited. During the mean observational periods of 14.7 years and 15.0 years (DS and non-DS, respectively) after the Fontan procedure, only one DS patient died. Central venous pressure (CVP) and transpulmonary pressure gradient significantly increased, and arterial oxygen saturation significantly decreased over time in DS patients after the Fontan procedure compared with those without DS. CVP in DS patients after the Fontan procedure increased over time compared with non-DS patients. Better management including the efficacy of Pulmonary arterial hypertension-specific therapy should be clarified in further studies. Patients with Down's syndrome (DS) are generally regarded as not being good candidates for the Fontan procedure. However, detailed hemodynamic changes over time are not fully clarified. A retrospective chart review of all patients with DS who underwent the Fontan procedure and 5 times that number of Fontan patients without DS performed in Fukuoka Children's Hospital and Kyushu University Hospital. Seven Fontan patients with DS were identified, and 35 Fontan patients without DS were recruited. During the mean observational periods of 14.7 years and 15.0 years (DS and non-DS, respectively) after the Fontan procedure, only one DS patient died. Central venous pressure (CVP) and transpulmonary pressure gradient significantly increased, and arterial oxygen saturation significantly decreased over time in DS patients after the Fontan procedure compared with those without DS. CVP in DS patients after the Fontan procedure increased over time compared with non-DS patients. Better management including the efficacy of Pulmonary arterial hypertension-specific therapy should be clarified in further studies. |
| Audience | Academic |
| Author | Ishikawa, Yuichi Umemoto, Shintaro Otsuka, Masakazu Sagawa, Koichi Tsutsui, Hiroyuki Nakamura, Makoto Ishikita, Ayako Kado, Hideaki Kuraoka, Ayako Nakano, Toshihide Sakamoto, Ichiro Kodama, Yoshihiko Ide, Tomomi |
| Author_xml | – sequence: 1 givenname: Masakazu surname: Otsuka fullname: Otsuka, Masakazu organization: Department of Pediatric Cardiology, Fukuoka Children’s Hospital – sequence: 2 givenname: Yoshihiko orcidid: 0000-0002-4836-7077 surname: Kodama fullname: Kodama, Yoshihiko email: kodamayoshihiko@gmail.com organization: Department of Pediatric Cardiology, Fukuoka Children’s Hospital, Department of Cardiovascular Medicine, Kyushu University Hospital – sequence: 3 givenname: Ayako surname: Kuraoka fullname: Kuraoka, Ayako organization: Department of Pediatric Cardiology, Fukuoka Children’s Hospital – sequence: 4 givenname: Yuichi surname: Ishikawa fullname: Ishikawa, Yuichi organization: Department of Pediatric Cardiology, Fukuoka Children’s Hospital – sequence: 5 givenname: Makoto surname: Nakamura fullname: Nakamura, Makoto organization: Department of Pediatric Cardiology, Fukuoka Children’s Hospital – sequence: 6 givenname: Toshihide surname: Nakano fullname: Nakano, Toshihide organization: Department of Cardiovascular Surgery, Fukuoka Children’s Hospital – sequence: 7 givenname: Hideaki surname: Kado fullname: Kado, Hideaki organization: Department of Cardiovascular Surgery, Fukuoka Children’s Hospital – sequence: 8 givenname: Shintaro surname: Umemoto fullname: Umemoto, Shintaro organization: Department of Cardiovascular Medicine, Kyushu University Hospital – sequence: 9 givenname: Ayako surname: Ishikita fullname: Ishikita, Ayako organization: Department of Cardiovascular Medicine, Kyushu University Hospital – sequence: 10 givenname: Ichiro surname: Sakamoto fullname: Sakamoto, Ichiro organization: Department of Cardiovascular Medicine, Kyushu University Hospital – sequence: 11 givenname: Tomomi surname: Ide fullname: Ide, Tomomi organization: Department of Cardiovascular Medicine, Kyushu University Hospital – sequence: 12 givenname: Hiroyuki surname: Tsutsui fullname: Tsutsui, Hiroyuki organization: Department of Cardiovascular Medicine, Kyushu University Hospital – sequence: 13 givenname: Koichi surname: Sagawa fullname: Sagawa, Koichi organization: Department of Pediatric Cardiology, Fukuoka Children’s Hospital |
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| Cites_doi | 10.1016/j.jtcvs.2013.02.017 10.1016/j.ijcard.2011.07.009 10.1161/JAHA.119.013691 10.1016/j.amjcard.2009.11.043 10.1136/heartjnl-2014-306378 10.1253/circj.CJ-17-0483 10.1016/j.athoracsur.2008.12.065 10.1016/0002-9149(83)90665-3 10.1093/cvr/4.1.23 10.1016/j.ijcard.2016.06.322 10.1186/s12872-017-0569-3 10.1111/chd.12521 10.1016/j.athoracsur.2019.07.085 10.1007/s11748-017-0809-6 10.1136/heartjnl-2015-307467 10.1016/j.jacc.2015.07.065 10.1093/ejcts/ezv072 10.1097/PCC.0000000000000007 10.1111/chd.12570 10.1136/thx.26.3.240 10.1111/j.1747-0803.2008.00237.x 10.1111/chd.12823 10.1016/j.ijcard.2008.02.025 |
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| Keywords | Down’s syndrome Central venous pressure Fontan procedure Pulmonary arterial hypertension-specific therapy |
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| Snippet | Patients with Down’s syndrome (DS) are generally regarded as not being good candidates for the Fontan procedure. However, detailed hemodynamic changes over... Patients with Down's syndrome (DS) are generally regarded as not being good candidates for the Fontan procedure. However, detailed hemodynamic changes over... |
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| SubjectTerms | Cardiac Surgery Cardiology Care and treatment Central Venous Pressure Child Down Syndrome - complications Fontan Procedure Heart Defects, Congenital - surgery Hemodynamics Humans Medicine Medicine & Public Health Original Article Pulmonary hypertension Retrospective Studies Vascular Surgery Venous pressure |
| Title | Hemodynamic Characteristics After Fontan Procedure in Patients with Down’s Syndrome |
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