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Case Reports
. 2022 Oct;43(7):1669-1673.
doi: 10.1007/s00246-022-02931-y. Epub 2022 Jun 9.

Improved Exercise Tolerance in an Adolescent Female After Failed Fontan and Subsequent Biventricular Conversion

Brittany Tang  1   2 , Angela Romme  3 , Rima Dababneh  3 , Sawsan Awad  3
Affiliations
Case Reports

Improved Exercise Tolerance in an Adolescent Female After Failed Fontan and Subsequent Biventricular Conversion

Brittany Tang et al. Pediatr Cardiol. 2022 Oct.

Abstract

We report a case of improved exercise tolerance in a single-ventricle patient following biventricular conversion. An 11 year old with a fenestrated extracardiac failing Fontan was accepted for a biventricular conversion repair at an out-of-town institution. The patient had multiple adverse cardiac events following Fontan surgery including recurrent pleural effusions, arteriovenous malformations, protein-losing enteropathy, and marked exercise intolerance. Serial cardiac catheterizations revealed chronic elevated pulmonary artery and Fontan pressures, normal left ventricular end-diastolic pressure and an adequately sized left ventricle. Cardiopulmonary exercise testing demonstrated severely reduced exercise tolerance due to ventilatory and cardiac limitations with significant arterial desaturations during exercise. Following a successful biventricular conversion, exercise tolerance improved remarkably, as evidenced by improved oxygen uptake and ventilatory efficiency. Our case demonstrates that biventricular conversion surgery may offer improvement in quality of life and exercise capacity in selected patients with failing Fontan physiology.

Keywords: Biventricular repair; Cardiopulmonary exercise test; Exercise tolerance; Fontan takedown.

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References

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