Complicaciones asociadas a la cirugía de Fontan realizada en pacientes pediátricos con cardiopatías congénitas – Revisión Sistemática

Abstract

Introduction: Complications associated with Fontan surgery represent a high incidence in both pediatric and adult patients, among the most frequent complications are cardiac and pulmonary due to the circulation system, therefore, they represent a great challenge for both patient’s physicians and patients undergoing this surgery. General objective: Complications associated with Fontan surgery performed in pediatric patients with congenital heart disease will be determined. Methodology: It is a systematic study without meta-analysis in which PRISMA-type methodology was used to search the literature. In addition, articles that meet the inclusion criteria will be used. For the development of the systematic review, the following scientific databases were selected: Scielo, Pubmed, Redalyc and Proquest. The search strategies focused on the identification of DECS terms, which correspond to: Congenital heart disease, Fontan surgery, complications, surgical technique, physiology. The languages used will be English – Spanish. For the analysis of bias, the CASP questionnaire will be used. Results: In Fontan patients, an increase in thoracic duct diameter with age is observed, associated with pleural effusion and higher functional class. High atrial volume indicates risk of arrhythmias. Severe liver disease is the most common complication, but recent surgery reduces its risk. Biomarkers such as NT-proBNP and GDF-15 predict cardiac events. Although long-term survival is possible, there is a risk of complications such as structural problems and arrhythmias, and plastic bronchitis varies according to the presence of coronary artery disease. Conclusions: The systematic review highlights common complications in Fontan surgery, such as liver disease and arrhythmias. Although long-term survival is possible, multidisciplinary approaches are needed to improve quality of life and prevent complications.