NDLI: Does the off-pump Fontan procedure ameliorate the volume and duration of pleural and peritoneal effusions?

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Does the off-pump Fontan procedure ameliorate the volume and duration of pleural and peritoneal effusions?

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Year: 2005 Volume: 28

Does the off-pump Fontan procedure ameliorate the volume and duration of pleural and peritoneal effusions?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Shikata, Fumiaki Yagihara, Toshikatsu Kagisaki, Koji Hagino, Ikuo Shiraishi, Shuichi Kobayashi, Junjiro Kitamura, Soichiro
Description	Country affiliation: Japan Author Affiliation: Shikata F ( Department of Cardiovascular Surgery, National Cardiovascular Center, Suita, Japan.)
Abstract	OBJECTIVE: We initiated an off-pump Fontan procedure by using temporary bypass from the inferior vena cava to the atrium and advanced the procedure in selected patients by simply cross-clamping the inferior vena cava. We aimed to investigate whether the off-pump Fontan procedure could ameliorate the volume and duration of pleural and peritoneal effusion. METHODS: We retrospectively reviewed 74 patients (aged <4 years) who underwent Fontan completion between January 2001 and December 2006. The patients were classified into the following two groups: a cardiopulmonary bypass group in which cardiopulmonary bypass was required (n=27) and an off-pump group in which the procedure was completed without the use of cardiopulmonary bypass (n=47). A propensity score was used to control the treatment selection bias for the use of cardiopulmonary bypass. Fourteen patients from each group were successfully matched. Both bilateral pleural and peritoneal drainage tubes were placed in all the patients. The total volume of the effusion was measured at 6, 12, 24, 48, and 72h postoperatively and was corrected for body weight (kg) and intervals (h). RESULTS: Significantly reduced effusion (ml/kg/h) was noted in the off-pump group compared to the cardiopulmonary bypass group at 12h (cardiopulmonary bypass group, 8.6 [4.8-11.5]; off-pump group, 2.5 [1.2-5.4]; p=0.006) and at 48h (cardiopulmonary bypass group, 6.1 [2.6-9.9]; off-pump group, 1.4 [0.9-3.1]; p=0.008). CONCLUSIONS: The off-pump Fontan procedure may reduce the volume of postoperative pleural and peritoneal effusion.
File Format	HTM / HTML
ISSN	10107940
e-ISSN	1873734X
Journal	European Journal of Cardio-Thoracic Surgery
Issue Number	3
Volume Number	34
Language	English
Publisher	Oxford University Press
Publisher Date	2008-09-01
Publisher Place	Germany
Access Restriction	Open
Subject Keyword	Discipline Cardiology__semicolon__surgery Ascitic Fluid Pathology Coronary Artery Bypass, Off-pump Fontan Procedure Pleural Effusion Prevention & Control Adolescent Metabolism Cardiopulmonary Bypass Adverse Effects Constriction Drainage Heart Defects, Congenital Surgery Etiology Postoperative Care Retrospective Studies
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine

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