American Journal of Cardiology
Volume 104, Issue 12 , Pages 1737-1742 , 15 December 2009

Atrial Remodeling After the Fontan Operation

  • Cordula M. Wolf, MD

      Affiliations

    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts
    • ,
  • Stephen P. Seslar, MD, PhD

      Affiliations

    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts
    • ,
  • Karen den Boer, MD

      Affiliations

    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts
    • ,
  • Amy L. Juraszek, MD

      Affiliations

    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts
    • Department of Pathology, Children's Hospital Boston, Boston, Massachusetts
    • ,
  • Francis X. McGowan, MD

      Affiliations

    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • Department of Cardiac Anesthesia, Children's Hospital Boston, Boston, Massachusetts
    • ,
  • Douglas B. Cowan, PhD

      Affiliations

    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • Department of Cardiac Anesthesia, Children's Hospital Boston, Boston, Massachusetts
    • ,
  • Pedro Del Nido, MD

      Affiliations

    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • Department of Cardiothoracic Surgery, Children's Hospital Boston, Boston, Massachusetts
    • ,
  • John K. Triedman, MD

      Affiliations

    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts
    • ,
  • Charles I. Berul, MD

      Affiliations

    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts
    • ,
  • Edward P. Walsh, MD

      Affiliations

    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts
    • Corresponding Author InformationCorresponding author: Tel: (617) 355-6328; fax: (617) 739-9058

Received 23 February 2009 ,Revised 29 July 2009 ,Accepted 29 July 2009.

References 

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  2. de Leval MR, Kilner P, Gewillig M, Bull C. Total cavopulmonary connection: a logical alternative to atriopulmonary connection for complex Fontan operations: Experimental studies and early clinical experience. J Thorac Cardiovasc Surg. 1988;96:682–695
  3. Doty DB, Marvin WJ, Lauer RM. Modified Fontan procedure: methods to achieve direct anastomosis of right atrium to pulmonary artery. J Thorac Cardiovasc Surg. 1981;81:470–475
  4. Corno A, Becker AE, Bulterijs AH, Lam J, Nijveld A, Schuller JL, et al. Univentricular heart: can we alter the natural history?. Ann Thorac Surg. 1982;34:716–727
  5. Balaji S, Gewillig M, Bull C, de Leval MR, Deanfield JE. Arrhythmias after the Fontan procedure: Comparison of total cavopulmonary connection and atriopulmonary connection. Circulation. 1991;84(Suppl):III162–III167
  6. Engelfriet P, Boersma E, Oechslin E, Tijssen J, Gatzoulis MA, Thilen U, et al. The spectrum of adult congenital heart disease in Europe: morbidity and mortality in a 5 year follow-up period: the Euro Heart Survey on adult congenital heart disease. Eur Heart J. 2005;26:2325–2333
  7. Gates RN, Laks H, Drinkwater DC, Lam L, Blitz A, Child JS, et al. The Fontan procedure in adults. Ann Thorac Surg. 1997;63:1085–1090
  8. Gelatt M, Hamilton RM, McCrindle BW, Gow RM, Williams WG, Trusler GA, et al. Risk factors for atrial tachyarrhythmias after the Fontan operation. J Am Coll Cardiol. 1994;24:1735–1741
  9. Mott AR, Feltes TF, McKenzie ED, Andropoulos DB, Bezold LI, Fenrich AL, et al. Improved early results with the Fontan operation in adults with functional single ventricle. Ann Thorac Surg. 2004;77:1334–1340
  10. Fishberger SB, Wernovsky G, Gentles TL, Gauvreau K, Burnett J, Mayer JE, et al. Factors that influence the development of atrial flutter after the Fontan operation. J Thorac Cadiovas Surg. 1997;113:80–86
  11. Bromberg BI, Schuessler RB, Gandhi SK, Rodefeld MD, Boineau JP, Huddleston CB. A canine model of atrial flutter following the intra-atrial lateral tunnel Fontan operation. J Electrocardiol. 1998;30:85–93
  12. Wong T, Davlouros PA, Li W, Millington-Sanders C, Francis DP, Gatzoulis MA. Mechanoelectrical interaction late after Fontan operation: relation between P-wave duration and dispersion, right atrial size, and atrial arrhythmias. Circulation. 2004;109:2319–2325
  13. Bush HL, Gelband H, Hoffman BF, Malm JR. Electrophysiological basis for supraventricular arrhythmias. Arch Surg. 1971;103:620–625
  14. Shirakura R, Kawashima Y, Hirose H, Matsuda H, Shimazaki Y, Sano T. Autopsy findings 14 years after septation for single ventricle. Ann Thorac Surg. 1989;48:124–125
  15. Thoele DG, Ursell PC, Ho SY, Smith A, Bowman FO, Gersony WM, et al. Atrial morphologic features in tricuspid atresia. J Thorac Cardiovasc Surg. 1991;102:606–610
  16. Yoshikawa Y, Ishibashi-Ueda H, Uemura H, Kawahira Y, Yagihara T. Pathologic findings in atrial musculature seven years after the intraatrial tunnel Fontan. Ann Thorac Surg. 2002;73:663–664
  17. McMahon CJ, Vatta M, Fraser CD, Towbin JA, Chang AC. Altered dystrophin expression in the right atrium of a patient after Fontan procedure with atrial flutter. (abstract) Heart. 2004;90:e65
  18. Nakagawa H, Shah N, Matsudaira K, Overholt E, Chandrasekaran K, Beckman KJ, et al. Characterization of reentrant circuit in macroreentrant right atrial tachycardia after surgical repair of congenital heart disease: isolated channels between scars allow “focal” ablation. Circulation. 2001;103:699–709
  19. Collins KK, Love BA, Walsh EP, Saul JP, Epstein MR, Triedman JK. Location of acutely, successful radiofrequency catheter ablation of intraatrial reentrant tachycardia in patients with congenital heart disease. Am J Cardiol. 2000;86:969–974
  20. Triedman JK, Alexander MA, Love BA, Collins KK, Berul CI, Bevilacqua LM, et al. Influence of patient factors and ablative technologies on outcomes of radiofrequency ablation of intra-atrial tachycardia in patients with congenital heart disease. J Am Coll Cardiol. 2002;39:1827–1835
  21. Bloom W. Blood and lymph vascular systems. In:  Bloom W,  Fawcett DW editor. A Textbook of Histology. Philadelphia: WB Saunders; 1975;p. 417–418

PII: S0002-9149(09)01496-9

doi: 10.1016/j.amjcard.2009.07.061

American Journal of Cardiology
Volume 104, Issue 12 , Pages 1737-1742 , 15 December 2009

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