Should we always plan a Fontan completion after a XXXX procedure?

@entity1 @entity1700 @entity2758 @entity998 @entity474 @entity2702 @entity849 @entity1146 @entity340 @entity72949
OBJECTIVE: To determine the late incidence of @entity2702 after bidirectional Glenn in @entity1 with azygos continuation of the inferior vena cava ( @entity72949 operation). METHODS: From 1990 to 2006, 21 @entity1 underwent a @entity72949 procedure at a median age of 2.3 years (0.5-8 years). Underlying anatomy included @entity474 [14], double-outlet right ventricle [13], @entity1146 [3], @entity849 [11], total @entity1700 [4] and bilateral superior vena cavae [14]. RESULTS: There was one hospital death after @entity72949 due to @entity998 . Follow-up was complete in all but one @entity1 . Two @entity1 died 23 days and 4 years after @entity72949 following cardiac reinterventions (one @entity340 and one Fontan completion). Thirteen @entity1 developed @entity2702 after a median of 4 years (2-9 years) after @entity72949 . Freedom from development of @entity2758 was 47% at 5 years (95% CI: 23-69%). A total of 16 @entity1 underwent Fontan completion, 12 for cyanosis related to @entity2702 and four for decreased exercise capacity. Only three @entity1 were left without Fontan completion at 4, 9 and 13 years after @entity72949 . The two @entity1 who had more than 9 years of follow-up after @entity72949 had antegrade flow preserved between the ventricle and the pulmonary arteries. CONCLUSION: Unless some hepatic blood flow is directed to both lungs, most, if not all @entity1 with a @entity72949 procedure will ultimately develop @entity2702 . Elective non-fenestrated Fontan completion in the years following @entity72949 procedure should be recommended.
