Quality of Life Assessment Following Direct Total Cavopulmonary Connection in Fontan Circulation: A Single Center Cross-Sectional Study

Authors

  • Kaiyu Wang Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Jiayu Chen The Second School of Clinical Medicine, Southern Medical University, 510091 Guangzhou, Guangdong, China; Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 510080 Guangzhou, Guangdong, China
  • Linjiang Han Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China
  • Binlin Yan Pulmonary and Critical Care Medicine, ShenZhen Yantian district people’s hospital, 518081 Shenzhen, Guangdong, China
  • Yushen Fang The Second School of Clinical Medicine, Southern Medical University, 510091 Guangzhou, Guangdong, China; Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 510080 Guangzhou, Guangdong, China
  • Yinru He Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China; Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 510080 Guangzhou, Guangdong, China
  • Hui Liu Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 510080 Guangzhou, Guangdong, China
  • Xiaobing Liu Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 510080 Guangzhou, Guangdong, China
  • Shusheng Wen Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 510080 Guangzhou, Guangdong, China
  • Jian Zhuang Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China; Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 510080 Guangzhou, Guangdong, China
  • Haiyun Yuan Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of South China Structural Heart Disease, 510080 Guangzhou, Guangdong, China; Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 510080 Guangzhou, Guangdong, China

DOI:

https://doi.org/10.59958/hsf.8049

Keywords:

direct total cavopulmonary connection, extracardiac conduit, Fontan procedure, congenital heart surgery

Abstract

Background: This study aims to compare the long-term outcomes and quality of survival between the direct total cavopulmonary connection (dTCPC) procedure and the standard extracardiac conduit (ECC) procedure in Fontan patients. Methods: A total of 31 participants who underwent the Fontan operation with either ECC (n = 15) or dTCPC (n = 16) at our institution were recruited between May 2023 and October 2023. Comprehensive evaluations included physical examinations, blood tests, targeted plasma metabolomics assays, cardiopulmonary exercise testing (CPET), and cardiac magnetic resonance imaging (CMR). Data collected from these assessments were analyzed and compared between the two groups. Results: The mean follow-up duration was longer in the dTCPC group (174.25 ± 63.06 months) compared to the ECC group (144.00 ± 43.70 months). No significant differences were observed in blood test parameters between the groups (p > 0.05). During CPET, two patients in the dTCPC group (12.5%) terminated the experiment due to a sudden decrease in exercise tolerance during the cycling process. Peak VO2 values were comparable between groups, with 20.29 ± 7.40 mL/min/kg in the dTCPC group versus 19.10 ± 7.93 mL/min/kg in the ECC group (p = 0.5939). Cardiac output in CMR revealed no significant differences between the two groups (5.28 ± 3.20 vs. 5.40 ± 2.85, p > 0.05). Additionally, flow measurements within the Fontan structure showed no significant differences (2.042 ± 1.0 vs. 2.023 ± 1.0], p > 0.05). Plasma metabolic profiling using targeted metabolomics demonstrated that the metabolic profiles of the two groups were broadly similar. Conclusions: The dTCPC procedure demonstrated similar outcomes to the ECC procedure in terms of exercise cardiopulmonary function, blood flow in central great vessels and plasma metabolic profiles. However, the long-term survival quality following dTCPC surgery, particularly regarding exercise capacity, may not fully meet expectations, highlighting the need for further refinement in surgical techniques and postoperative management.

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Published

2024-12-22

How to Cite

Wang, K., Chen, J., Han, L., Yan, B., Fang, Y., He, Y., Liu, H., Liu, X., Wen, S., Zhuang, J., & Yuan, H. (2024). Quality of Life Assessment Following Direct Total Cavopulmonary Connection in Fontan Circulation: A Single Center Cross-Sectional Study. The Heart Surgery Forum, 27(12), E1404-E1413. https://doi.org/10.59958/hsf.8049

Issue

Vol. 27 No. 12 (2024)

Section

Article

Copyright (c) 2024 The Author(s)

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