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• W2065031157 abstract "Fontan palliation and its variants are the most widely used and accepted approach for regulating pulmonary blood flow and relieving cyanosis in patients with single-ventricle physiology. 1 Fontan F. Baudet E. Surgical repair of tricuspid atresia. Thorax. 1971; 26: 240-248 Crossref PubMed Scopus (1973) Google Scholar First-generation Fontan procedures involved connection of the right atrium (RA) to the pulmonary artery (PA). However, this frequently caused RA dilation, sluggish RA flow, and atrial fibrosis and was associated with a high incidence of atrial arrhythmias. 2 Laks H. Milliken J.C. Perloff J.K. et al. Experience with the Fontan procedure. J Thorac Cardiovasc Surg. 1984; 88: 939-951 PubMed Google Scholar , 3 Bae E. Lee J. Noh C. et al. Sinus node dysfunction after Fontan modifications—influence of surgical method. Int J Cardiol. 2003; 88: 285-291 Abstract Full Text Full Text PDF PubMed Scopus (42) Google Scholar Exclusion of most or all of the RA decreases the incidence of atrial arrhythmias; therefore, the Fontan procedure evolved with the establishment of a total cavopulmonary connection by way of either the lateral tunnel (an intra-atrial tunnel) or the extracardiac Fontan. 4 AboulHosn J.A. Shavelle D.M. Castellon Y. et al. Fontan operation and the single ventricle. Congenit Heart Dis. 2007; 2: 211 Google Scholar , 5 Aboulhosn J. Child J.S. The adult with a Fontan operation. Curr Cardiol Rep. 2007; 9: 331-335 Crossref PubMed Scopus (12) Google Scholar Patients who have undergone first-generation RA–PA Fontan surgery with subsequent development of atrial arrhythmias may benefit from surgical conversion to total cavopulmonary connection with concomitant arrhythmia surgery. 6 Mavroudis C. Backer C.L. Deal B.J. et al. Total cavopulmonary conversion and maze procedure for patients with failure of the Fontan operation. J Thorac Cardiovasc Surg. 2001; 122: 863-871 Abstract Full Text Full Text PDF PubMed Scopus (167) Google Scholar , 7 Mavroudis C. Deal B.J. Backer C.L. The beneficial effects of total cavopulmonary conversion and arrhythmia surgery for the failed Fontan. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2002; 5: 12-24 Abstract Full Text PDF PubMed Scopus (59) Google Scholar Despite a significant reduction in arrhythmia burden, a subgroup of patients still develop recurrent arrhythmias. 8 Mavroudis C. Deal B.J. Backer C.L. et al. J. Maxwell Chamberlain Memorial Paper for congenital heart surgery 111 Fontan conversions with arrhythmia surgery: surgical lessons and outcomes. Ann. Thorac. Surg. 2007; 84: 1457-1465 Abstract Full Text Full Text PDF PubMed Scopus (144) Google Scholar The extracardiac Fontan consists of an inferior vena cava to PA conduit and direct connection of the superior vena cava to the PA. As the procedure is performed completely outside the heart, it is thought to be associated with fewer arrhythmic sequelae. 9 Kim S. Kim W. Lim H. et al. Outcome of 200 patients after an extracardiac Fontan procedure. J Thorac Cardiovasc Surg. 2008; 136: 108-116 Abstract Full Text Full Text PDF PubMed Scopus (139) Google Scholar However, the conduit is made of stiff Gore-Tex, which precludes access into the heart. This report outlines an approach to catheter ablation in a patient with extracardiac Fontan palliation in which the heart was accessed via the conduit." @default.
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• W2065031157 date "2010-03-01" @default.
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• W2065031157 title "Transconduit puncture for catheter ablation of atrial tachycardia in a patient with extracardiac Fontan palliation" @default.
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