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Similarities and differences in the exercise performance of patients after a modified Fontan procedure compared to patients with complete transposition following a Senning operation

Published online by Cambridge University Press:  19 August 2008

Gernot Buheitel ,
Michael Hofbeck ,
Stephan Gerling ,
Andreas Koch  and
Helmut Singer
Gernot Buheitel*
Affiliation:
Department of Pediatric Cardiology, University Childrens Hospital Erlangen, Germany
Michael Hofbeck
Affiliation:
Department of Pediatric Cardiology, University Childrens Hospital Erlangen, Germany
Stephan Gerling
Affiliation:
Department of Pediatric Cardiology, University Childrens Hospital Erlangen, Germany
Andreas Koch
Affiliation:
Department of Pediatric Cardiology, University Childrens Hospital Erlangen, Germany
Helmut Singer
Affiliation:
Department of Pediatric Cardiology, University Childrens Hospital Erlangen, Germany
*
PD Dr. G. Buheitel, Abteilung für Kinderkardiologie, Univ. Kinderklinik, Loschgestr. 15 D–91054 Erlangen, Germany. Tel: +49–9131–8533750; Fax: +49–9131–8535987
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Abstract

Objective

To investigate cardiopulmonary performance in patients after a Fontan procedure, comparing it to patients following a Senning operation.

Methods

We studied 21 children, with a mean age of 11.1 years, after a total cavopulmonary anastomosis, comparing them to 13 with complete transposition after a Senning procedure, having a mean age of 11.8 years, and 21 control subjects with a mean age of 11.2 years. All were tested on a bicycle ergospirometer.

Results

Peak consumption of oxygen, maximal work rate, peak oxygen pulse and endexpiratory pressure of carbon dioxide at a work rate of 1.5 Watt/kg were lowest in patients with a modified Fontan procedure, and highest in the control group (p ≤ 0.0278). Production of carbon dioxide, and minute ventilation at a work rate of 1.5 Watt/kg, was highest in the patients after Fontan procedure, and lowest in the healthy subjects (p ≤ 0.0163). Production of carbon dioxide per single breath was lower in those having a Fontan procedure (28.9 ml) than in the two other groups (35.1 ml; p = 0.0243). The tidal volume showed no significant differences between the three groups.

Conclusions

The reaction to exercise was identical qualitatively in both groups of patients, and comparable to the behaviour of patients with chronic heart failure. Quantitatively, the results of the patients following a Senning procedure lay between those of control subjects and those who had undergone a Fontan operation. The only exception was dead space ventilation, where the patients after a Fontan procedure differed from the two other groups because of their increased ventilation-perfusion mismatch.

Keywords

Congenital heart diseaseFontancomplete transpositiontotal cavopulmonary connectionexercise testing
Type
Original Articles
Information
Cardiology in the Young , Volume 10 , Issue 3 , May 2000 , pp. 201 - 207
Copyright
Copyright © Cambridge University Press 2000

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