Therapeutic implications of intraoperative pressure measurements after the fontan operation

Christopher J. Knott-Craig, Hartzell V Schaff, Francisco J. Puga, Paul R. Julsrud, Dale G. Gehring, Gordon K. Danielson

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Central venous pressure (CVP) and left atrial pressure (LAP) were monitored continuously for the first 72 hours postoperatively in 32 patients who underwent a Fontan operation in whom preoperative measurements of the pulmonary artery index were available. Integrated mean values were generated for each patient for the following time frames: (1) the first 12 hours after operation, (2) the first 24 hours after operation, (3) postoperative day 2, and (4) postoperative day 3. We found no difference in the CVP, LAP, or transpulmonary gradient, derived as CVP - LAP, measured in the operating room at the completion of the operation versus that measured on the third postoperative day: CVP, 18 ± 2 mm Hg versus 19 ± 3 mm Hg; LAP, 10 ± 2 mm Hg versus 10 ± 3 mm Hg; and transpulmonary gradient, 8 ± 2 mm Hg versus 8 ± 2 mm Hg. The combined incidence of hospital mortality and postoperative takedown associated with the Fontan repair was 12.5%. These findings suggest that a poor hemodynamic result from the Fontan operation can be predicted from intraoperative pressure measurements, because the CVP, LAP, and transpulmonary gradient are unlikely to change significantly in the early postoperative period. Therefore, a decision to take down or fenestrate the repair can reasonably be nude in the operating room or the early postoperative period.

Original languageEnglish (US)
Pages (from-to)937-939
Number of pages3
JournalThe Annals of Thoracic Surgery
Volume57
Issue number4
StatePublished - Apr 1994

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Fontan Procedure
Central Venous Pressure
Atrial Pressure
Pressure
Operating Rooms
Postoperative Period
Therapeutics
Hospital Mortality
Pulmonary Artery
Hemodynamics
Incidence

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Knott-Craig, C. J., Schaff, H. V., Puga, F. J., Julsrud, P. R., Gehring, D. G., & Danielson, G. K. (1994). Therapeutic implications of intraoperative pressure measurements after the fontan operation. The Annals of Thoracic Surgery, 57(4), 937-939.

Therapeutic implications of intraoperative pressure measurements after the fontan operation. / Knott-Craig, Christopher J.; Schaff, Hartzell V; Puga, Francisco J.; Julsrud, Paul R.; Gehring, Dale G.; Danielson, Gordon K.

In: The Annals of Thoracic Surgery, Vol. 57, No. 4, 04.1994, p. 937-939.

Research output: Contribution to journalArticle

Knott-Craig, CJ, Schaff, HV, Puga, FJ, Julsrud, PR, Gehring, DG & Danielson, GK 1994, 'Therapeutic implications of intraoperative pressure measurements after the fontan operation', The Annals of Thoracic Surgery, vol. 57, no. 4, pp. 937-939.
Knott-Craig CJ, Schaff HV, Puga FJ, Julsrud PR, Gehring DG, Danielson GK. Therapeutic implications of intraoperative pressure measurements after the fontan operation. The Annals of Thoracic Surgery. 1994 Apr;57(4):937-939.
Knott-Craig, Christopher J. ; Schaff, Hartzell V ; Puga, Francisco J. ; Julsrud, Paul R. ; Gehring, Dale G. ; Danielson, Gordon K. / Therapeutic implications of intraoperative pressure measurements after the fontan operation. In: The Annals of Thoracic Surgery. 1994 ; Vol. 57, No. 4. pp. 937-939.
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