BACKGROUND: Conversion to total extracardiac cavopulmonary @entity254 is an option for managing @entity1 with dysfunction of a prior Fontan connection. METHODS: Thirty-one @entity1 (19.9 +/- 8.8 years) underwent revision of a previous Fontan connection to total extracardiac cavopulmonary @entity254 at four institutions. Complications of the previous Fontan connection included @entity4710 (n = 20), progressive @entity712 (n = 17), Fontan pathway obstruction (n = 10), effusions (n = 10), @entity3885 by an enlarged right atrium (n = 6), @entity6518 (n = 3), right @entity715 (n = 2), @entity475 (n = 1), @entity338 (n = 3), and Fontan baffle leak (n = 5). Conversion to an extracardiac cavopulmonary connection was performed with a nonvalved conduit from the inferior vena cava to the right pulmonary artery, with additional procedures as necessary. RESULTS: There have been 3 deaths. Two @entity1 died in the perioperative period of @entity712 and massive effusions. The third @entity1 died suddenly 8 months after the operation. All surviving @entity1 were in New York Heart Association class I (n = 20) or II (n = 7), except for 1 @entity1 who underwent heart transplantation. Early postoperative @entity943 occurred in 10 @entity1 : 4 required pacemakers, and medical therapy was sufficient in 6. In 15 @entity1 , pre-revision @entity943 were improved. Effusions resolved in all but 1 of the @entity1 in whom they were present before revision. The condition of 2 @entity1 with @entity6518 improved within 30 days. CONCLUSIONS: Conversion of a failing Fontan connection to extracardiac cavopulmonary connection can be achieved with low morbidity and mortality. Optimally, revision should be undertaken early in symptomatic @entity1 before irreversible @entity67 .

Revision of previous Fontan connections to total extracardiac cavopulmonary XXXX : A multicenter experience.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity3885 :: ('MESH:D008173', 'Disease') :: ['pulmonary venous obstruction'] @entity6518 :: ('MESH:D011504', 'Disease') :: ['protein-losing enteropathy'] @entity475 :: ('MESH:C564793', 'Disease') :: ['subaortic stenosis'] @entity338 :: ('MESH:D011665', 'Disease') :: ['atrioventricular valve regurgitation'] @entity4710 :: ('MESH:D013617', 'Disease') :: ['atrial tachyarrhythmias'] @entity67 :: ('MESH:D018754', 'Disease') :: ['ventricular failure ensues'] @entity943 :: ('MESH:D001145', 'Disease') :: ['arrhythmias'] @entity715 :: ('MESH:D013927', 'Disease') :: ['atrial thrombus']
@entity254 :: (MESH:C563598,Disease) :: ['anastomosis']
