Katogi Toshiyuki
Saitama Medical University, Saitama International Medical Center, 1397-1, Yamane, Hidaka, Saitama, Japan.
Gen Thorac Cardiovasc Surg. 2012 Dec;60(12):792-5. doi: 10.1007/s11748-012-0161-9. Epub 2012 Oct 18.
The Fontan procedure has provided excellent surgical palliation for patients with various types of univentricular hearts, and it has evolved over time. Among many modifications, the lateral tunnel Fontan connection (LTF) and the extracardiac Fontan connection (ECF) are currently the most popular techniques for completing the total cavopulmonary connection. The advantages and disadvantages of both techniques are reviewed here. The advantages of the ECF includes adaptability to all types of univentricular hearts, ease of construction without aortic cross clamping and fewer atrial suture lines. The advantages of the LTF include the ability to complete Fontan circulation in young, very small patients with potential for growth. This review also compares post-operative arrhythmias and fluid dynamics associated with both techniques.
Fontan手术为各种类型的单心室心脏患者提供了出色的手术姑息治疗，并且随着时间的推移不断发展。在众多改良方法中，侧隧道Fontan连接（LTF）和心外Fontan连接（ECF）是目前完成全腔肺连接最常用的技术。本文回顾了这两种技术的优缺点。ECF的优点包括适用于所有类型的单心室心脏、无需主动脉阻断即可轻松构建且心房缝合线较少。LTF的优点包括能够在有生长潜力的年轻、非常小的患者中完成Fontan循环。本综述还比较了与这两种技术相关的术后心律失常和流体动力学。
