TOTAL CAVOPULMONARY ANASTOMOSIS IN PATIENTS LESS-THAN 3 YEARS OF AGE

Background. As young age at modified Fontan operation was thought to b e a preoperative risk factor for poorer survival, we studied early and intermediate outcome in our young patient group. Methods. Results in children less than 3 years of age (group I; n = 26; age range, 7 to 35 months) were compared with those in older patients (group II; n = 46; age range, 36 to 219 months). For both groups there was no significan t difference with regard to preoperative pathology and hemodynamics. R esults. With an overall mortality of 9.7% (7/72) there was no signific ant difference for both groups. Group I (n = 23) and group II (n = 42) survivors did not differ with respect to early postoperative incidenc e of atrial dysrhythmias, duration and volume of pleural effusion, or incidence of reoperation. Results on intermediate follow-up (group I, 31 +/- 14 months; group II, 44 +/- 20 months) demonstrated a relativel y low incidence of late atrial dysrhythmias (12.3%; 8/65). Late atriov entricular valve insufficiency was significantly more frequent in grou p I patients. Conclusions. With similar preoperative anatomic and hemo dynamic parameters including 68% of patients with complex univentricul ar heart, total cavopulmonary anastomosis could be performed in patien ts less than 3 years of age with good clinical and hemodynamic results , as achieved in older patients.