Early experience with extracardiac Fontan operation

Background. The extracardiac Fontan (ECFO) operation has gained more widesp read use over last decade. In this article we analyze our early experience with ECFO. Methods. Thirty-three patients underwent ECFO at median age 4.1 years. Norm othermic perfusion with the heart beating was used in 24 patients and cardi oplegia in 7, Fenestration was not performed in the last 16 patients who un derwent surgery without cardioplegia. Results. The hospital mortality was 6% (2 patients). Necessity or duration of inotropic support, duration of mechanical ventilation, intensive care un it and hospital stay, and incidence of prolonged pleural effusions of patie nts operated on without cardioplegia were shorter and the rate of complicat ions in these patients was lower than in patients who underwent cardioplegi a. Conclusions. Our preliminary experience shows that ECFO can be performed in many patients with normothermic cardiopulmonary bypass and without cardiop legia and fenestration. Avoidance of cardioplegia seems to decrease postope rative morbidity. Incidence of early postoperative arrhythmias is low. Desp ite encouraging early results, longer follow-up is necessary to prove the r eal advantages of ECFO. (Ann Thorac Surg 2001;71:71-7) (C) 2001 by The Soci ety of Thoracic Surgeons.