XXXX . Comparison of results with a modified Fontan procedure.

@entity1 @entity1145 @entity2150 @entity600 @entity358 @entity299 @entity1146 @entity340 @entity4297
Several modifications of the Fontan principle are currently applied to the treatment of @entity1145 with low mortality. The use of these modifications in other @entity600 has most frequently been associated with less satisfactory results. At our institution, from June 1977 to October 1986, 35 consecutive @entity1 , whose ages ranged from 8 months to 20 years (median age 3.4 years), underwent a modified Fontan procedure. Twenty @entity1 with a median age of 3.2 years (group I) having @entity1145 (16 @entity1 ) or @entity2150 right @entity299 (four @entity1 ) were treated by means of a right @entity358 (12 @entity1 ) or right atrium-subpulmonary chamber connection (eight @entity1 ). Fifteen @entity1 (group II) with a median age of 3.6 years, having a single left ventricle (10 @entity1 ), left @entity340 or @entity1146 (three @entity1 ), or double-outlet right ventricle (two @entity1 ), underwent right @entity358 , together with a repositioning of the atrial septum to the right of the right atrioventricular valve, which thus left intact the inlet to the ventricle(s). The operative mortality rate was 25% in group I and 0% in group II. One @entity1 in group I and one in group II died late postoperatively. All the 28 survivors are free of symptoms 3 months to 9 years after correction. According to our results, low risk can be associated with modified Fontan procedures in the treatment of @entity4297 other than tricuspid or @entity1146 . Preserving the integrity of the entire inlet to the ventricle(s) by repositioning the interatrial septum, as done in group II @entity600 , might be helpful in improving the quality of the repair.
