BACKGROUND:Most single ventricle patients undergo Fontan procedure in a staged manner. However, optimal timing of Fontan completion after an intermediate staging surgery is controversial. Therefore, we investigated the long-term impact of age at Fontan completion on the exercise performance in adolescents. METHODS:We analyzed National Institutes of Health/National Heart, Lung and Blood Institute Pediatric Heart Network Fontan Cross-Sectional Study dataset consisting of children and adolescents 6 to 18 years of age recruited in 2003 to 2004. Multivariate linear regression techniques were used to evaluate association of age at Fontan procedure with percent predicted VO2 maximum, percent predicted maximum O2 pulse, and heart rate reserve in patients who achieved ventilatory anaerobic threshold (VAT). RESULTS:Of the 405 patients who had undergone only one Fontan operation and ramp cycle ergometry, 72% had prior intermediate surgery. Mean age at Fontan completion and exercise testing was 3.4±2 and 12.4±3.2 years. Three hundred twelve patients reached VAT suggesting adequate cardiopulmonary effort. In patients who reached VAT, each year increase in age at Fontan completion was associated with a decline of 1.5 (95% CI -2.5 to -0.5) points in percent-predicted VO2 maximum and a decline of 4.1 (95% CI -6.0 to -2.1) beat/min in heart rate reserve after adjusting for all pertinent variables. CONCLUSIONS:Fontan completion at a younger age is associated with better exercise performance in adolescents.

译文

背景:大多数单心室患者分阶段接受Fontan手术。然而,中级分期手术后丰坦完成的最佳时机存在争议。因此,我们调查了丰坦完成年龄对青少年运动表现的长期影响。
方法:我们分析了美国国立卫生研究院/国家心脏,肺和血液研究所儿科心脏网络Fontan跨部门研究数据集,该数据集由2003年至2004年招募的6至18岁的儿童和青少年组成。使用多元线性回归技术进行评估达到通气性无氧阈值(VAT)的患者中Fontan手术的年龄与最大VO2预测百分比,最大O2脉冲预测百分比以及心率储备之间的相关性。
结果:在仅接受过一次Fontan手术和斜波测功的405例患者中,有72%曾接受过中级手术。丰坦完成和运动测试的平均年龄为3.4±2岁和12.4±3.2岁。 312名患者达到了增值税,表明有足够的心肺功能。在达到增值税的患者中,丰坦完成时年龄的每年增加与百分比最大预测VO2值下降1.5(95%CI -2.5至-0.5)点相关,而下降4.1(95%CI -6.0至95%CI -6.0)。 -2.1)调整所有相关变量后,心跳储备的心跳/分钟。
结论:年轻时的丰坦完成与青少年更好的运动表现有关。

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