Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism
Abstract. The Fenestrated Fontan procedure (FFP) has improved outcome in high risk patients. The technique is evolving, however, and complications are not fully known. Over a 3-year period 13 patients (mean age 35 ± 29 months) underwent an FFP in our institution. In the first two patients the fenest...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
|---|
| Format: |
E-Artikel |
|---|---|
| Sprache: |
Englisch |
| Erschienen: |
1997 |
|---|
| Umfang: |
4 |
|---|
| Reproduktion: |
Springer Online Journal Archives 1860-2002 |
|---|---|
| Übergeordnetes Werk: |
in: Pediatric cardiology - 1979, 18(1997) vom: März, Seite 218 -221 |
| Übergeordnetes Werk: |
volume:18 ; year:1997 ; month:03 ; pages:218 -221 ; extent:4 |
| Links: |
|---|
| Katalog-ID: |
NLEJ207157855 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLEJ207157855 | ||
| 003 | DE-627 | ||
| 005 | 20230506154314.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 070528s1997 xx |||||o 00| ||eng c | ||
| 035 | |a (DE-627)NLEJ207157855 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 245 | 1 | 0 | |a Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism |
| 264 | 1 | |c 1997 | |
| 300 | |a 4 | ||
| 336 | |a nicht spezifiziert |b zzz |2 rdacontent | ||
| 337 | |a nicht spezifiziert |b z |2 rdamedia | ||
| 338 | |a nicht spezifiziert |b zu |2 rdacarrier | ||
| 520 | |a Abstract. The Fenestrated Fontan procedure (FFP) has improved outcome in high risk patients. The technique is evolving, however, and complications are not fully known. Over a 3-year period 13 patients (mean age 35 ± 29 months) underwent an FFP in our institution. In the first two patients the fenestration had to be created because of high right atrial pressure and low cardiac output; in 11 patients the FFP was planned. In three patients the sutures for the adjustable fenestration were crossing the defect. In 10 patients, purse-string sutures were placed around but not across the defect. Because large fenestrations were created in 11 patients (8–12 mm) Glenn shunts were performed to improve arterial saturation. The postoperative course was relatively uneventful, with chest tubes being removed 1–8 days (mean 4 ± 3 days) postoperatively and the hospital stay ranging from 7 to 27 days (mean 14 ± 6 days). One patient had bleeding and another had a mediastinal abscess. The first patient died (7.6%) because of hemodynamic instability due to prolonged cardiopulmonary bypass from the creation and enlargement of the fenestration. One patient had a paradoxical cerebral embolism from clots that formed on the sutures crossing the fenestration. Because of this problem the remaining patients were placed on salicylates while awaiting closure of their fenestration. All 12 patients had their fenestrations closed, performed under local anesthesia in 9, at mediastinal abscess drainage in 1, and spontaneously in 2. We conclude that creation of large fenestrations in combination with Glenn shunts and the use of adjustable fenestrations are viable modifications of the FFP. The use of purse-string sutures around the fenestration and antiplatelet drugs can probably minimize the occurrence of paradoxical embolism. | ||
| 533 | |f Springer Online Journal Archives 1860-2002 | ||
| 700 | 1 | |a Quinones, J.A. |4 oth | |
| 700 | 1 | |a Deleon, S.Y. |4 oth | |
| 700 | 1 | |a Bell, T.J. |4 oth | |
| 700 | 1 | |a Cetta, F. |4 oth | |
| 700 | 1 | |a Moffa, S.M. |4 oth | |
| 700 | 1 | |a Freeman, J.E. |4 oth | |
| 700 | 1 | |a Vitullo, D.A. |4 oth | |
| 700 | 1 | |a Fisher, E.A. |4 oth | |
| 773 | 0 | 8 | |i in |t Pediatric cardiology |d 1979 |g 18(1997) vom: März, Seite 218 -221 |w (DE-627)NLEJ188994300 |w (DE-600)1463000-x |x 1432-1971 |7 nnns |
| 773 | 1 | 8 | |g volume:18 |g year:1997 |g month:03 |g pages:218 -221 |g extent:4 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s002469900154 |
| 912 | |a GBV_USEFLAG_U | ||
| 912 | |a ZDB-1-SOJ | ||
| 912 | |a GBV_NL_ARTICLE | ||
| 951 | |a AR | ||
| 952 | |d 18 |j 1997 |c 3 |h 218 -221 |g 4 | ||
| matchkey_str |
article:14321971:1997----::eetaefnapoeuevltootcnqenocreco |
|---|---|
| hierarchy_sort_str |
1997 |
| publishDate |
1997 |
| allfields |
(DE-627)NLEJ207157855 DE-627 ger DE-627 rakwb eng Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism 1997 4 nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Abstract. The Fenestrated Fontan procedure (FFP) has improved outcome in high risk patients. The technique is evolving, however, and complications are not fully known. Over a 3-year period 13 patients (mean age 35 ± 29 months) underwent an FFP in our institution. In the first two patients the fenestration had to be created because of high right atrial pressure and low cardiac output; in 11 patients the FFP was planned. In three patients the sutures for the adjustable fenestration were crossing the defect. In 10 patients, purse-string sutures were placed around but not across the defect. Because large fenestrations were created in 11 patients (8–12 mm) Glenn shunts were performed to improve arterial saturation. The postoperative course was relatively uneventful, with chest tubes being removed 1–8 days (mean 4 ± 3 days) postoperatively and the hospital stay ranging from 7 to 27 days (mean 14 ± 6 days). One patient had bleeding and another had a mediastinal abscess. The first patient died (7.6%) because of hemodynamic instability due to prolonged cardiopulmonary bypass from the creation and enlargement of the fenestration. One patient had a paradoxical cerebral embolism from clots that formed on the sutures crossing the fenestration. Because of this problem the remaining patients were placed on salicylates while awaiting closure of their fenestration. All 12 patients had their fenestrations closed, performed under local anesthesia in 9, at mediastinal abscess drainage in 1, and spontaneously in 2. We conclude that creation of large fenestrations in combination with Glenn shunts and the use of adjustable fenestrations are viable modifications of the FFP. The use of purse-string sutures around the fenestration and antiplatelet drugs can probably minimize the occurrence of paradoxical embolism. Springer Online Journal Archives 1860-2002 Quinones, J.A. oth Deleon, S.Y. oth Bell, T.J. oth Cetta, F. oth Moffa, S.M. oth Freeman, J.E. oth Vitullo, D.A. oth Fisher, E.A. oth in Pediatric cardiology 1979 18(1997) vom: März, Seite 218 -221 (DE-627)NLEJ188994300 (DE-600)1463000-x 1432-1971 nnns volume:18 year:1997 month:03 pages:218 -221 extent:4 http://dx.doi.org/10.1007/s002469900154 GBV_USEFLAG_U ZDB-1-SOJ GBV_NL_ARTICLE AR 18 1997 3 218 -221 4 |
| spelling |
(DE-627)NLEJ207157855 DE-627 ger DE-627 rakwb eng Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism 1997 4 nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Abstract. The Fenestrated Fontan procedure (FFP) has improved outcome in high risk patients. The technique is evolving, however, and complications are not fully known. Over a 3-year period 13 patients (mean age 35 ± 29 months) underwent an FFP in our institution. In the first two patients the fenestration had to be created because of high right atrial pressure and low cardiac output; in 11 patients the FFP was planned. In three patients the sutures for the adjustable fenestration were crossing the defect. In 10 patients, purse-string sutures were placed around but not across the defect. Because large fenestrations were created in 11 patients (8–12 mm) Glenn shunts were performed to improve arterial saturation. The postoperative course was relatively uneventful, with chest tubes being removed 1–8 days (mean 4 ± 3 days) postoperatively and the hospital stay ranging from 7 to 27 days (mean 14 ± 6 days). One patient had bleeding and another had a mediastinal abscess. The first patient died (7.6%) because of hemodynamic instability due to prolonged cardiopulmonary bypass from the creation and enlargement of the fenestration. One patient had a paradoxical cerebral embolism from clots that formed on the sutures crossing the fenestration. Because of this problem the remaining patients were placed on salicylates while awaiting closure of their fenestration. All 12 patients had their fenestrations closed, performed under local anesthesia in 9, at mediastinal abscess drainage in 1, and spontaneously in 2. We conclude that creation of large fenestrations in combination with Glenn shunts and the use of adjustable fenestrations are viable modifications of the FFP. The use of purse-string sutures around the fenestration and antiplatelet drugs can probably minimize the occurrence of paradoxical embolism. Springer Online Journal Archives 1860-2002 Quinones, J.A. oth Deleon, S.Y. oth Bell, T.J. oth Cetta, F. oth Moffa, S.M. oth Freeman, J.E. oth Vitullo, D.A. oth Fisher, E.A. oth in Pediatric cardiology 1979 18(1997) vom: März, Seite 218 -221 (DE-627)NLEJ188994300 (DE-600)1463000-x 1432-1971 nnns volume:18 year:1997 month:03 pages:218 -221 extent:4 http://dx.doi.org/10.1007/s002469900154 GBV_USEFLAG_U ZDB-1-SOJ GBV_NL_ARTICLE AR 18 1997 3 218 -221 4 |
| allfields_unstemmed |
(DE-627)NLEJ207157855 DE-627 ger DE-627 rakwb eng Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism 1997 4 nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Abstract. The Fenestrated Fontan procedure (FFP) has improved outcome in high risk patients. The technique is evolving, however, and complications are not fully known. Over a 3-year period 13 patients (mean age 35 ± 29 months) underwent an FFP in our institution. In the first two patients the fenestration had to be created because of high right atrial pressure and low cardiac output; in 11 patients the FFP was planned. In three patients the sutures for the adjustable fenestration were crossing the defect. In 10 patients, purse-string sutures were placed around but not across the defect. Because large fenestrations were created in 11 patients (8–12 mm) Glenn shunts were performed to improve arterial saturation. The postoperative course was relatively uneventful, with chest tubes being removed 1–8 days (mean 4 ± 3 days) postoperatively and the hospital stay ranging from 7 to 27 days (mean 14 ± 6 days). One patient had bleeding and another had a mediastinal abscess. The first patient died (7.6%) because of hemodynamic instability due to prolonged cardiopulmonary bypass from the creation and enlargement of the fenestration. One patient had a paradoxical cerebral embolism from clots that formed on the sutures crossing the fenestration. Because of this problem the remaining patients were placed on salicylates while awaiting closure of their fenestration. All 12 patients had their fenestrations closed, performed under local anesthesia in 9, at mediastinal abscess drainage in 1, and spontaneously in 2. We conclude that creation of large fenestrations in combination with Glenn shunts and the use of adjustable fenestrations are viable modifications of the FFP. The use of purse-string sutures around the fenestration and antiplatelet drugs can probably minimize the occurrence of paradoxical embolism. Springer Online Journal Archives 1860-2002 Quinones, J.A. oth Deleon, S.Y. oth Bell, T.J. oth Cetta, F. oth Moffa, S.M. oth Freeman, J.E. oth Vitullo, D.A. oth Fisher, E.A. oth in Pediatric cardiology 1979 18(1997) vom: März, Seite 218 -221 (DE-627)NLEJ188994300 (DE-600)1463000-x 1432-1971 nnns volume:18 year:1997 month:03 pages:218 -221 extent:4 http://dx.doi.org/10.1007/s002469900154 GBV_USEFLAG_U ZDB-1-SOJ GBV_NL_ARTICLE AR 18 1997 3 218 -221 4 |
| allfieldsGer |
(DE-627)NLEJ207157855 DE-627 ger DE-627 rakwb eng Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism 1997 4 nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Abstract. The Fenestrated Fontan procedure (FFP) has improved outcome in high risk patients. The technique is evolving, however, and complications are not fully known. Over a 3-year period 13 patients (mean age 35 ± 29 months) underwent an FFP in our institution. In the first two patients the fenestration had to be created because of high right atrial pressure and low cardiac output; in 11 patients the FFP was planned. In three patients the sutures for the adjustable fenestration were crossing the defect. In 10 patients, purse-string sutures were placed around but not across the defect. Because large fenestrations were created in 11 patients (8–12 mm) Glenn shunts were performed to improve arterial saturation. The postoperative course was relatively uneventful, with chest tubes being removed 1–8 days (mean 4 ± 3 days) postoperatively and the hospital stay ranging from 7 to 27 days (mean 14 ± 6 days). One patient had bleeding and another had a mediastinal abscess. The first patient died (7.6%) because of hemodynamic instability due to prolonged cardiopulmonary bypass from the creation and enlargement of the fenestration. One patient had a paradoxical cerebral embolism from clots that formed on the sutures crossing the fenestration. Because of this problem the remaining patients were placed on salicylates while awaiting closure of their fenestration. All 12 patients had their fenestrations closed, performed under local anesthesia in 9, at mediastinal abscess drainage in 1, and spontaneously in 2. We conclude that creation of large fenestrations in combination with Glenn shunts and the use of adjustable fenestrations are viable modifications of the FFP. The use of purse-string sutures around the fenestration and antiplatelet drugs can probably minimize the occurrence of paradoxical embolism. Springer Online Journal Archives 1860-2002 Quinones, J.A. oth Deleon, S.Y. oth Bell, T.J. oth Cetta, F. oth Moffa, S.M. oth Freeman, J.E. oth Vitullo, D.A. oth Fisher, E.A. oth in Pediatric cardiology 1979 18(1997) vom: März, Seite 218 -221 (DE-627)NLEJ188994300 (DE-600)1463000-x 1432-1971 nnns volume:18 year:1997 month:03 pages:218 -221 extent:4 http://dx.doi.org/10.1007/s002469900154 GBV_USEFLAG_U ZDB-1-SOJ GBV_NL_ARTICLE AR 18 1997 3 218 -221 4 |
| allfieldsSound |
(DE-627)NLEJ207157855 DE-627 ger DE-627 rakwb eng Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism 1997 4 nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Abstract. The Fenestrated Fontan procedure (FFP) has improved outcome in high risk patients. The technique is evolving, however, and complications are not fully known. Over a 3-year period 13 patients (mean age 35 ± 29 months) underwent an FFP in our institution. In the first two patients the fenestration had to be created because of high right atrial pressure and low cardiac output; in 11 patients the FFP was planned. In three patients the sutures for the adjustable fenestration were crossing the defect. In 10 patients, purse-string sutures were placed around but not across the defect. Because large fenestrations were created in 11 patients (8–12 mm) Glenn shunts were performed to improve arterial saturation. The postoperative course was relatively uneventful, with chest tubes being removed 1–8 days (mean 4 ± 3 days) postoperatively and the hospital stay ranging from 7 to 27 days (mean 14 ± 6 days). One patient had bleeding and another had a mediastinal abscess. The first patient died (7.6%) because of hemodynamic instability due to prolonged cardiopulmonary bypass from the creation and enlargement of the fenestration. One patient had a paradoxical cerebral embolism from clots that formed on the sutures crossing the fenestration. Because of this problem the remaining patients were placed on salicylates while awaiting closure of their fenestration. All 12 patients had their fenestrations closed, performed under local anesthesia in 9, at mediastinal abscess drainage in 1, and spontaneously in 2. We conclude that creation of large fenestrations in combination with Glenn shunts and the use of adjustable fenestrations are viable modifications of the FFP. The use of purse-string sutures around the fenestration and antiplatelet drugs can probably minimize the occurrence of paradoxical embolism. Springer Online Journal Archives 1860-2002 Quinones, J.A. oth Deleon, S.Y. oth Bell, T.J. oth Cetta, F. oth Moffa, S.M. oth Freeman, J.E. oth Vitullo, D.A. oth Fisher, E.A. oth in Pediatric cardiology 1979 18(1997) vom: März, Seite 218 -221 (DE-627)NLEJ188994300 (DE-600)1463000-x 1432-1971 nnns volume:18 year:1997 month:03 pages:218 -221 extent:4 http://dx.doi.org/10.1007/s002469900154 GBV_USEFLAG_U ZDB-1-SOJ GBV_NL_ARTICLE AR 18 1997 3 218 -221 4 |
| language |
English |
| source |
in Pediatric cardiology 18(1997) vom: März, Seite 218 -221 volume:18 year:1997 month:03 pages:218 -221 extent:4 |
| sourceStr |
in Pediatric cardiology 18(1997) vom: März, Seite 218 -221 volume:18 year:1997 month:03 pages:218 -221 extent:4 |
| format_phy_str_mv |
Article |
| institution |
findex.gbv.de |
| isfreeaccess_bool |
false |
| container_title |
Pediatric cardiology |
| authorswithroles_txt_mv |
Quinones, J.A. @@oth@@ Deleon, S.Y. @@oth@@ Bell, T.J. @@oth@@ Cetta, F. @@oth@@ Moffa, S.M. @@oth@@ Freeman, J.E. @@oth@@ Vitullo, D.A. @@oth@@ Fisher, E.A. @@oth@@ |
| publishDateDaySort_date |
1997-03-01T00:00:00Z |
| hierarchy_top_id |
NLEJ188994300 |
| id |
NLEJ207157855 |
| language_de |
englisch |
| fullrecord |
<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">NLEJ207157855</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230506154314.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">070528s1997 xx |||||o 00| ||eng c</controlfield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)NLEJ207157855</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">1997</subfield></datafield><datafield tag="300" ind1=" " ind2=" "><subfield code="a">4</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zzz</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">z</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zu</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Abstract. The Fenestrated Fontan procedure (FFP) has improved outcome in high risk patients. The technique is evolving, however, and complications are not fully known. Over a 3-year period 13 patients (mean age 35 ± 29 months) underwent an FFP in our institution. In the first two patients the fenestration had to be created because of high right atrial pressure and low cardiac output; in 11 patients the FFP was planned. In three patients the sutures for the adjustable fenestration were crossing the defect. In 10 patients, purse-string sutures were placed around but not across the defect. Because large fenestrations were created in 11 patients (8–12 mm) Glenn shunts were performed to improve arterial saturation. The postoperative course was relatively uneventful, with chest tubes being removed 1–8 days (mean 4 ± 3 days) postoperatively and the hospital stay ranging from 7 to 27 days (mean 14 ± 6 days). One patient had bleeding and another had a mediastinal abscess. The first patient died (7.6%) because of hemodynamic instability due to prolonged cardiopulmonary bypass from the creation and enlargement of the fenestration. One patient had a paradoxical cerebral embolism from clots that formed on the sutures crossing the fenestration. Because of this problem the remaining patients were placed on salicylates while awaiting closure of their fenestration. All 12 patients had their fenestrations closed, performed under local anesthesia in 9, at mediastinal abscess drainage in 1, and spontaneously in 2. We conclude that creation of large fenestrations in combination with Glenn shunts and the use of adjustable fenestrations are viable modifications of the FFP. The use of purse-string sutures around the fenestration and antiplatelet drugs can probably minimize the occurrence of paradoxical embolism.</subfield></datafield><datafield tag="533" ind1=" " ind2=" "><subfield code="f">Springer Online Journal Archives 1860-2002</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Quinones, J.A.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Deleon, S.Y.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Bell, T.J.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Cetta, F.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Moffa, S.M.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Freeman, J.E.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Vitullo, D.A.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Fisher, E.A.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">in</subfield><subfield code="t">Pediatric cardiology</subfield><subfield code="d">1979</subfield><subfield code="g">18(1997) vom: März, Seite 218 -221</subfield><subfield code="w">(DE-627)NLEJ188994300</subfield><subfield code="w">(DE-600)1463000-x</subfield><subfield code="x">1432-1971</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:18</subfield><subfield code="g">year:1997</subfield><subfield code="g">month:03</subfield><subfield code="g">pages:218 -221</subfield><subfield code="g">extent:4</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">http://dx.doi.org/10.1007/s002469900154</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_U</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">ZDB-1-SOJ</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_NL_ARTICLE</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">18</subfield><subfield code="j">1997</subfield><subfield code="c">3</subfield><subfield code="h">218 -221</subfield><subfield code="g">4</subfield></datafield></record></collection>
|
| series2 |
Springer Online Journal Archives 1860-2002 |
| ppnlink_with_tag_str_mv |
@@773@@(DE-627)NLEJ188994300 |
| format |
electronic Article |
| delete_txt_mv |
keep |
| collection |
NL |
| remote_str |
true |
| illustrated |
Not Illustrated |
| issn |
1432-1971 |
| topic_title |
Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism |
| format_facet |
Elektronische Aufsätze Aufsätze Elektronische Ressource |
| format_main_str_mv |
Text Zeitschrift/Artikel |
| carriertype_str_mv |
zu |
| author2_variant |
j q jq s d sd t b tb f c fc s m sm j f jf d v dv e f ef |
| hierarchy_parent_title |
Pediatric cardiology |
| hierarchy_parent_id |
NLEJ188994300 |
| hierarchy_top_title |
Pediatric cardiology |
| isfreeaccess_txt |
false |
| familylinks_str_mv |
(DE-627)NLEJ188994300 (DE-600)1463000-x |
| title |
Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism |
| spellingShingle |
Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism |
| ctrlnum |
(DE-627)NLEJ207157855 |
| title_full |
Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism |
| journal |
Pediatric cardiology |
| journalStr |
Pediatric cardiology |
| lang_code |
eng |
| isOA_bool |
false |
| recordtype |
marc |
| publishDateSort |
1997 |
| contenttype_str_mv |
zzz |
| container_start_page |
218 |
| container_volume |
18 |
| physical |
4 |
| format_se |
Elektronische Aufsätze |
| title_sort |
fenestrated fontan procedure: evolution of technique and occurrence of paradoxical embolism |
| title_auth |
Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism |
| abstract |
Abstract. The Fenestrated Fontan procedure (FFP) has improved outcome in high risk patients. The technique is evolving, however, and complications are not fully known. Over a 3-year period 13 patients (mean age 35 ± 29 months) underwent an FFP in our institution. In the first two patients the fenestration had to be created because of high right atrial pressure and low cardiac output; in 11 patients the FFP was planned. In three patients the sutures for the adjustable fenestration were crossing the defect. In 10 patients, purse-string sutures were placed around but not across the defect. Because large fenestrations were created in 11 patients (8–12 mm) Glenn shunts were performed to improve arterial saturation. The postoperative course was relatively uneventful, with chest tubes being removed 1–8 days (mean 4 ± 3 days) postoperatively and the hospital stay ranging from 7 to 27 days (mean 14 ± 6 days). One patient had bleeding and another had a mediastinal abscess. The first patient died (7.6%) because of hemodynamic instability due to prolonged cardiopulmonary bypass from the creation and enlargement of the fenestration. One patient had a paradoxical cerebral embolism from clots that formed on the sutures crossing the fenestration. Because of this problem the remaining patients were placed on salicylates while awaiting closure of their fenestration. All 12 patients had their fenestrations closed, performed under local anesthesia in 9, at mediastinal abscess drainage in 1, and spontaneously in 2. We conclude that creation of large fenestrations in combination with Glenn shunts and the use of adjustable fenestrations are viable modifications of the FFP. The use of purse-string sutures around the fenestration and antiplatelet drugs can probably minimize the occurrence of paradoxical embolism. |
| abstractGer |
Abstract. The Fenestrated Fontan procedure (FFP) has improved outcome in high risk patients. The technique is evolving, however, and complications are not fully known. Over a 3-year period 13 patients (mean age 35 ± 29 months) underwent an FFP in our institution. In the first two patients the fenestration had to be created because of high right atrial pressure and low cardiac output; in 11 patients the FFP was planned. In three patients the sutures for the adjustable fenestration were crossing the defect. In 10 patients, purse-string sutures were placed around but not across the defect. Because large fenestrations were created in 11 patients (8–12 mm) Glenn shunts were performed to improve arterial saturation. The postoperative course was relatively uneventful, with chest tubes being removed 1–8 days (mean 4 ± 3 days) postoperatively and the hospital stay ranging from 7 to 27 days (mean 14 ± 6 days). One patient had bleeding and another had a mediastinal abscess. The first patient died (7.6%) because of hemodynamic instability due to prolonged cardiopulmonary bypass from the creation and enlargement of the fenestration. One patient had a paradoxical cerebral embolism from clots that formed on the sutures crossing the fenestration. Because of this problem the remaining patients were placed on salicylates while awaiting closure of their fenestration. All 12 patients had their fenestrations closed, performed under local anesthesia in 9, at mediastinal abscess drainage in 1, and spontaneously in 2. We conclude that creation of large fenestrations in combination with Glenn shunts and the use of adjustable fenestrations are viable modifications of the FFP. The use of purse-string sutures around the fenestration and antiplatelet drugs can probably minimize the occurrence of paradoxical embolism. |
| abstract_unstemmed |
Abstract. The Fenestrated Fontan procedure (FFP) has improved outcome in high risk patients. The technique is evolving, however, and complications are not fully known. Over a 3-year period 13 patients (mean age 35 ± 29 months) underwent an FFP in our institution. In the first two patients the fenestration had to be created because of high right atrial pressure and low cardiac output; in 11 patients the FFP was planned. In three patients the sutures for the adjustable fenestration were crossing the defect. In 10 patients, purse-string sutures were placed around but not across the defect. Because large fenestrations were created in 11 patients (8–12 mm) Glenn shunts were performed to improve arterial saturation. The postoperative course was relatively uneventful, with chest tubes being removed 1–8 days (mean 4 ± 3 days) postoperatively and the hospital stay ranging from 7 to 27 days (mean 14 ± 6 days). One patient had bleeding and another had a mediastinal abscess. The first patient died (7.6%) because of hemodynamic instability due to prolonged cardiopulmonary bypass from the creation and enlargement of the fenestration. One patient had a paradoxical cerebral embolism from clots that formed on the sutures crossing the fenestration. Because of this problem the remaining patients were placed on salicylates while awaiting closure of their fenestration. All 12 patients had their fenestrations closed, performed under local anesthesia in 9, at mediastinal abscess drainage in 1, and spontaneously in 2. We conclude that creation of large fenestrations in combination with Glenn shunts and the use of adjustable fenestrations are viable modifications of the FFP. The use of purse-string sutures around the fenestration and antiplatelet drugs can probably minimize the occurrence of paradoxical embolism. |
| collection_details |
GBV_USEFLAG_U ZDB-1-SOJ GBV_NL_ARTICLE |
| title_short |
Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism |
| url |
http://dx.doi.org/10.1007/s002469900154 |
| remote_bool |
true |
| author2 |
Quinones, J.A. Deleon, S.Y. Bell, T.J. Cetta, F. Moffa, S.M. Freeman, J.E. Vitullo, D.A. Fisher, E.A. |
| author2Str |
Quinones, J.A. Deleon, S.Y. Bell, T.J. Cetta, F. Moffa, S.M. Freeman, J.E. Vitullo, D.A. Fisher, E.A. |
| ppnlink |
NLEJ188994300 |
| mediatype_str_mv |
z |
| isOA_txt |
false |
| hochschulschrift_bool |
false |
| author2_role |
oth oth oth oth oth oth oth oth |
| up_date |
2024-07-06T08:55:06.268Z |
| _version_ |
1803819266887122944 |
| fullrecord_marcxml |
<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">NLEJ207157855</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230506154314.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">070528s1997 xx |||||o 00| ||eng c</controlfield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)NLEJ207157855</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Fenestrated Fontan Procedure: Evolution of Technique and Occurrence of Paradoxical Embolism</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">1997</subfield></datafield><datafield tag="300" ind1=" " ind2=" "><subfield code="a">4</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zzz</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">z</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zu</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Abstract. The Fenestrated Fontan procedure (FFP) has improved outcome in high risk patients. The technique is evolving, however, and complications are not fully known. Over a 3-year period 13 patients (mean age 35 ± 29 months) underwent an FFP in our institution. In the first two patients the fenestration had to be created because of high right atrial pressure and low cardiac output; in 11 patients the FFP was planned. In three patients the sutures for the adjustable fenestration were crossing the defect. In 10 patients, purse-string sutures were placed around but not across the defect. Because large fenestrations were created in 11 patients (8–12 mm) Glenn shunts were performed to improve arterial saturation. The postoperative course was relatively uneventful, with chest tubes being removed 1–8 days (mean 4 ± 3 days) postoperatively and the hospital stay ranging from 7 to 27 days (mean 14 ± 6 days). One patient had bleeding and another had a mediastinal abscess. The first patient died (7.6%) because of hemodynamic instability due to prolonged cardiopulmonary bypass from the creation and enlargement of the fenestration. One patient had a paradoxical cerebral embolism from clots that formed on the sutures crossing the fenestration. Because of this problem the remaining patients were placed on salicylates while awaiting closure of their fenestration. All 12 patients had their fenestrations closed, performed under local anesthesia in 9, at mediastinal abscess drainage in 1, and spontaneously in 2. We conclude that creation of large fenestrations in combination with Glenn shunts and the use of adjustable fenestrations are viable modifications of the FFP. The use of purse-string sutures around the fenestration and antiplatelet drugs can probably minimize the occurrence of paradoxical embolism.</subfield></datafield><datafield tag="533" ind1=" " ind2=" "><subfield code="f">Springer Online Journal Archives 1860-2002</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Quinones, J.A.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Deleon, S.Y.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Bell, T.J.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Cetta, F.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Moffa, S.M.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Freeman, J.E.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Vitullo, D.A.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Fisher, E.A.</subfield><subfield code="4">oth</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">in</subfield><subfield code="t">Pediatric cardiology</subfield><subfield code="d">1979</subfield><subfield code="g">18(1997) vom: März, Seite 218 -221</subfield><subfield code="w">(DE-627)NLEJ188994300</subfield><subfield code="w">(DE-600)1463000-x</subfield><subfield code="x">1432-1971</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:18</subfield><subfield code="g">year:1997</subfield><subfield code="g">month:03</subfield><subfield code="g">pages:218 -221</subfield><subfield code="g">extent:4</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">http://dx.doi.org/10.1007/s002469900154</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_U</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">ZDB-1-SOJ</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_NL_ARTICLE</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">18</subfield><subfield code="j">1997</subfield><subfield code="c">3</subfield><subfield code="h">218 -221</subfield><subfield code="g">4</subfield></datafield></record></collection>
|
| score |
7.4003916 |