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DOI: 10.1055/s-0029-1191527
Arrhythmia incidence after the intracardiac lateral tunnel Fontan completion versus the extracardiac conduit
Objectives: Early (within 30 days) and late arrhythmias (after 6 months) are relatively common following completion of the Fontan operation in its original form, which contributes significantly to late morbidity and mortality. Aim of the study was to compare a consecutive series of Fontan patients who had undergone Fontan completion either using an intracardiac lateral tunnel or an extracardiac conduit, for early and late arrhythmia incidence.
Methods: The early postoperative course and follow-up data of 51 consecutive survivors were analysed. The patients fell into 2 categories: those with an intracardiac lateral tunnel Fontan completion (ILT – n=26); median age at Fontan completion 5.5 years; follow-up 58 to 120 months) versus an extracardiac conduit (ECC – n=25; median age at Fontan completion 3.4 years; follow-up 8 to 84 months).
Results: Early postoperative arrhythmias (sinus node disease, AV block, intraatrial re-entrant tachycardia) were observed in 14 patients (9 ILT versus 5 ECC) Late arrhythmias (sinus node disease, AV block, intraatrial re-entrant tachycardia, VT) were documented in 15 patients (13 ILT versus 2 ECC). There was 1 late death in the ILT subgroup, which was unrelated to arrhythmia.
Conclusion: While the two groups differ substantially in terms of age at Fontan completion and duration of follow-up, these data suggest that the incidence of both early and late arrhythmias appears to be considerably diminished following the routine use of ECC Fontan completion. The often predicted absence of arrhythmias in extracardiac tunnel Fontan patients can not be justified.