Fontan completion during winter season is not associated with higher mortality or morbidity in the early post-operative period

Cardiol Young. 2020 May;30(5):629-632. doi: 10.1017/S1047951120000670. Epub 2020 Apr 13.

Abstract

Objectives: The aim of our study was to compare post-operative outcome after total cavopulmonary connection between patients operated during winter and summer season.

Methods: We retrospectively studied 211 patients who underwent extracardiac total cavopulmonary connection completion at our institution between 1995 and 2015 (median age 4 (1-42) years). Seventy (33%) patients were operated during winter (November to March) and 141 (67%) patients during summer season (April to October).

Results: Patients operated during winter and summer season showed no difference in early mortality (7% versus 5%, p = 0.52) and severe morbidity like need for early Fontan takedown (1% versus 1%, p = 0.99) and need for mechanical circulatory support (9% versus 4%, p = 0.12). The post-operative course and haemodynamic outcome were comparable between both groups of patients (ICU (4 versus 3 days, p = 0.44) and hospital stay (15 versus 14 days, p = 0.28), prolonged pleural effusions (36% versus 31%, p = 0.51), need for dialysis (16% versus 11%, p = 0.37), ascites (37% versus 33%, p = 0.52), supraventricular tachyarrhythmia (16% versus 13%, p = 0.56) and chylothorax (26% versus 16%, p = 0.12), change of antibiotic treatment (47% versus 36%, p = 0.06), prolonged inotropic support (24% versus 14%, p = 0.05), intubation time (15 versus 12 hours, p = 0.33), and incidence of fast-track extubation (11% versus 22%, p = 0.06).

Conclusion: Outcomes after total cavopulmonary connection completion during winter and summer season were comparably related to mortality, severe morbidity, or longer hospital stay in the early post-operative period. These results suggest that total cavopulmonary connection completion during winter season is as safe as during summer season.

Keywords: Total cavopulmonary connection; early post-operative outcome; winter season.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Female
  • Fontan Procedure / methods*
  • Fontan Procedure / mortality
  • Germany / epidemiology
  • Heart Defects, Congenital / epidemiology
  • Heart Defects, Congenital / surgery*
  • Hemodynamics
  • Humans
  • Infant
  • Length of Stay
  • Male
  • Morbidity / trends
  • Postoperative Complications / epidemiology*
  • Postoperative Period
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Seasons*
  • Survival Rate / trends
  • Treatment Outcome
  • Young Adult