Ermis Peter R, Morales David L S
Baylor College of Medicine, Houston, Texas, USA.
Methodist Debakey Cardiovasc J. 2011 Apr-Jun;7(2):3-8. doi: 10.14797/mdcj-7-2-3.
Congenital heart disease is the most common birth defect, with an estimated incidence of moderate to severe disease of 4-6 per 1,000 live births. Due to the dramatic advances in cardiac surgery and general pediatric cardiology care, approximately 85% of neonates with congenital heart disease (CHD) survive to adulthood. The most recent information, published in 2004, estimated 787,800 to 1.3 million adults with CHD living in the United States. This is expected to increase by 5% per year. It is estimated that within the next decade, 1 in every 150 young adults will have some form of CHD. DUe to the changing therapeutic options, a higher percentage of the adult CHD population will consist of more complicated cardiac disease during the coming years. It is estimated that 1-2% of children with CHD have single-ventricle physiology. Thus, as survival in this complex portion of the CHD population improves, the number of adult patients with previous Fontan palliation will dramatically increase. The goal of this article is to provide a brief background of the Fontan procedure and then discuss the late-term outcomes and complications in this unique patient type. The majority of the article will focus on information needed to adequately care for the adult Fontan patient.
先天性心脏病是最常见的出生缺陷，据估计，中重度疾病的发病率为每1000例活产中有4至6例。由于心脏外科手术和小儿心脏病学综合护理的巨大进步，约85%的先天性心脏病（CHD）新生儿能存活至成年。2004年发布的最新信息估计，美国有787,800至130万成年CHD患者。预计这一数字将以每年5%的速度增长。据估计，在未来十年内，每150名年轻人中就有1人患有某种形式的CHD。由于治疗选择的变化，未来几年成年CHD患者中，患有更复杂心脏病的比例将更高。据估计，1%至2%的CHD儿童具有单心室生理特征。因此，随着这一复杂CHD患者群体生存率的提高，接受过Fontan姑息手术的成年患者数量将大幅增加。本文的目的是简要介绍Fontan手术的背景，然后讨论这类特殊患者的远期结局和并发症。本文大部分内容将聚焦于为成年Fontan患者提供充分护理所需的信息。
