HYBRID EVENT: You can participate in person at Paris, France or Virtually from your home or work.

3rd Edition of International Heart Congress

June 05-07,2025 | Hybrid Event

June 05 -07, 2025 | Rome, Italy
Heart Congress 2024

Outcomes of fenestrated versus non-fenestrated in fontan procedure: A systemic review and meta-analysis

Prima Abdillah Akbar, Speaker at Heart Conferences
Airlangga University, Indonesia
Title : Outcomes of fenestrated versus non-fenestrated in fontan procedure: A systemic review and meta-analysis

Abstract:

Introduction: Numerous investigations examining fenestration in the Fontan procedure have presented inconsistent findings regarding its effectiveness in improving surgical outcomes. The objective of this meta -analysis is to contrast the early results of fenestrated versus non-fenestrated Fontan procedures.

Method: Literature search was performed using PubMed, Science Direct and Research Gate for obtaining studies comparing Fenestrated and Non-Fenestrated in Fontan Procedure, published between 1992 and 2022. The primary outcome was overall mortality. Secondary outcomes included CPB time, post-operative oxygen saturation, prolonged pleural effusion, ICU stays, hospital stay, fontan failure, and survival rate.

Results: There was a significant difference in terms of cardiopulmonary bypass (CPB) time between both groups (MD, 12.66; 95% CI, [2.87, 22.46]; p = 0.01, I2 = 36%). Significant difference was also observed for post-operative oxygen saturation between the 2 groups (MD, -3.46; 95% CI, [-5.96, 0.96]; p = 0.007, I2 = 89%). Analysis for the outcome prolonged pleural effusion revealed significant difference between two groups (OR, 0.47, 95% CI, [0.24, 0.93]; p = 0.03, I2 = 84%; Fig. 4). Analysis of ICU stay did not show a significant difference between 2 groups (MD, -0.51; 95% CI, [-0.51, 0.68]; p = 0.77, I2 = 45%). A trend of lower hospital length of stay occurrence was observed in the Fenestrated group, however no significant difference was observed (MD, -1.30, 95% CI, [-3.79, 1.18]; p = 0.05, I2 = 0%). Similar finding was revealed in term of fontan failure (OR, 0.69, 95% CI, [0.42, 1.13]; p = 0.14, I2 = 60%). Analysis of Mortality did not show a significant difference between 2 groups (OR, 1.13, 95% CI, [0.55, 2.31]; p = 0.74, I2 = 31%). Similar findings also found in Survival Rate where there was no difference between 2 groups. (OR, 1.04, 95% CI, [0.84,1.30]; p = 0.70, I2 = 0%).

Conclusion: CPB time was found longer in fenestrated group compared to non-fenestrated group. Post-operative oxygen saturation was found higher in non-fenestrated group, whereas prolonged pleural effusion was found in non-fenestrated group. There was no significant difference in terms of ICU stays, hospital stays, fontan failure, mortality and survival rate.

Keywords: Fontan Procedure; Fenestrated; Non-Fenestrated; Outcomes.

Audience Take Away:

The presentation would provide a comprehensive overview of the procedural outcomes about the early results of fenestrated versus non-fenestrated Fontan procedures, shedding light on the comparative effectiveness of these approaches. Here are the specific learning points and benefits the audience can expect:

  • Clinical Decision-Making:
    The presentation will enable surgeons and clinicians to make more informed decisions regarding the selection of fenestrated or non-fenestrated Fontan procedures based on detailed comparative outcomes like CPB time, post-operative oxygen saturation, and pleural effusion
  • Research and Educational Impact:
    The findings serve as a valuable resource for further research into Fontan procedures and provide a solid educational foundation for teaching medical students and residents about evidence-based practices in pediatric cardiac surgery
  • Improved Patient Outcomes:
    By providing evidence-based insights into procedural outcomes, the research helps in refining surgical techniques and patient management strategies, ultimately aiming to improve patient recovery and procedure effectiveness
  • Interdisciplinary Collaboration and Policy Formulation:
    Encourages collaboration between different medical specialists and helps healthcare administrators in formulating policies or guidelines that standardize care processes, enhancing overall healthcare delivery in pediatric cardiac surgery

Biography:

Prima Abdillah Akbar pursued his medical education at the Faculty of Medicine, Muhammadiyah University of Malang, from 2009 to 2016. He is currently undergoing residency training in thoracic, cardiac, and vascular surgery at the Faculty of Medicine, Airlangga University

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