Abhishek Prabhu¹,Mahadev Damodar Dixit², Mohan Dattatraya Gan³, Veeresh Manvi⁴

¹Postgraduate student, Department of Cardio Vascular and Thoracic Surgery, ²Professor, Department of Cardio Vascular and Thoracic Surgery, ³Professor and head, Department of Cardio Vascular and Thoracic Surgery, ⁴ Paediatric Cardiologist, Jawaharlal Nehru Medical College and Karnataka Lingayat Educational Society's Dr.Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka.

Corresponding Author: Dr. Abhishek Prabhu, Postgraduate student, Department of Cardio Vascular and Thoracic Surgery, Jawaharlal Nehru Medical College and Karnataka Lingayat Educational Society's Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka.

Introduction:The Fontan operation is usually the final palliative procedure in patients with niventricular heart. The objectives of this study were firstly to describe the clinical and hemodynamic characteristics of a group of patients with univentricular physiology who had previously been palliated with a right modified Blalock Taussig's Shunt, Bidirectional Glenn Shunt and secondly to identify the risk factors that can influence post-operative outcomes after Fontan operation.

Materials and Methods: A retrospective analysis of 20 patients who underwent Fontan operation between January 2005 to January 2014 was conducted. Clinical characteristics, catheterization data, type and duration of surgery were reviewed and analysed as predictors of post-operative outcome.

Results: We operated 20 cases out of which 14 were males and 6 were females. The majority of the patients (10) were in the age group of 11-20 years. The diagnosis included double outlet right ventricle (DORV) 5 patients, ventricular septal defect with pulmonary stenosis 5 patients, transposition of great arteries (TGA) 3 patients, tricuspid atresia (TA) 6 patients and double inlet left ventricle with pulmonary stenosis (DILV, PS) 1 patient. Out of these, 4 patients were palliated with right modified Blalock-Taussig (BT) shunt, and 6 patients with Glenn Shunt. The rest were for the direct Fontan procedure. Two patients died during the postoperative period.

Conclusion: The performance of hemodynamic study before Fontan operation made it possible to select high risk patients for surgery. Fontan operation showed dramatic improvements in symptoms and saturations.

Keywords :Fontan procedure, Univentricular heart,Cardiac catheterization