Loomba, RS; Frommelt, PC; Anderson, RH; Flores, S; Tweddell, JS. Timing of Fontan Completion in Children with Functionally Univentricular Hearts and Isomerism The Impact of Age, Weight, and Pre-Fontan Arterial Oxygen Saturation. Pediatric Cardiology. 2019; 40(4):753-761.
The following should be taken into consideration when timing Fontan completion in patients with isomerism: age, arterial oxygen saturation, pulmonary arteriovenous malformations, interruption of the inferior caval vein, and atrioventricular valve regurgitation. Fontan completion should occur before arterial oxygen saturations decrease to 82%, even if prior to 3.5 years of age.
Lorts, A; Villa, C; Riggs, KW; Broderick, J; Morales, DLS. First Use of HeartMate 3 in a Failing Fontan Circulation. Annals of Thoracic Surgery. 2018; 106(5):e233-e234.
There is a growing wave of patients with end-stage failing Fontan circulations for which transplant alone cannot address because of the limitation of donor hearts. This experience demonstrates how the newest VAD technology can be successfully used to chronically palliate well-selected Fontan patients as a potential option other than transplantation.
Moore, RA; Riggs, KW; Kourtidou, S; Schneider, K; Szugye, N; Troja, W; D'Souza, G; Rattan, M; III, BR; Taylor, MD; Morales, DLS. Three-dimensional printing and virtual surgery for congenital heart procedural planning. Birth Defects Research. 2018; 110(13):1082-1090.
Individualized health care is a definitive direction in which medicine is going and the use of virtual surgery to plan out a specific patient’s surgery—especially complex ones—is an example of this. As our field sees the increasing toll of single ventricle palliation, we at Cincinnati Children's Hospital Medical Center have been performing more complex two ventricle repairs. Virtual surgery has been used in some of these cases and the authors have found it to be quite helpful in the planning and execution of these operations. However, further technological development and formal assessment will be required to understand the true impact of this technology.
Reagor, JA; Clingan, S; Kulat, BT; Matte, GS; Voss, J; Tweddell, JS. The Norwood Stage 1 procedure-conduct of perfusion 2017 Survey results from NPC-QIC member institutions. Perfusion. 2018; 33(8):667-678.
Perfusionists and cardiac surgeons developed the NPC-QIC’s first conduct of perfusion survey for the Norwood Stage 1 procedure, specifically targeting the provision of cardiopulmonary bypass for patients with hypoplastic left heart syndrome (HLHS). This manuscript discusses the results of this survey, unveiling significant variance in the conduct of perfusion for this patient population.