Fontan Completion for Younger than 3 Years of Age: Outcome in Patients with Functional Single Ventricle

Most single ventricle patients undergo Fontan procedure earlier in current era. However, optimal timing of Fontan completion after an intermediate staging surgery is controversial. We present children who had Fontan surgeries younger than 3 years of age comparing the data with older patients. Between 2000 and 2013, 45 patients with functional single ventricle underwent extracardiac total cavopulmonary connection (TCPC) using GORE-TEX^® conduit at a single institution. Children were divided into group A (age < 36 months; n = 15) and group B (age ≥ 36 months; n = 30), and retrospectively reviewed. Median follow-up was 2.9 [interquartile range (IQR) 2–4.4] years. There were two hospital deaths and one late death (all in group B, p = 0.286). One TCPC was taken down in group A. The median intensive care unit and hospital stay were 90 (IQR 46–140) h and 21 (IQR 16–33) days for group A versus 65 (IQR 45–115) h and 29 (IQR 20.8–38.5) days for group B, respectively (p = 0.322 and p = 0.057). Ventricular ejection fraction and GORE-TEX^® conduit size were similar in both groups. The time of chest drain stay was significantly lower in group A (median 12 days, IQR 7–22) than in group B (22 days, IQR 16–32.5) (p = 0.014). Extracardiac TCPC can be performed earlier with good intermediate results. Earlier Fontan procedure might be advantageous for reducing chest drains stay.