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- Title
Effectiveness of Carvedilol for Congestive Heart Failure that Developed Long after Modified Fontan Operation.
- Authors
Ishibashi, Naoko; In-Sam Park; Takahashi, Yukiko; Nishiyama, Mitsunori; Murakami, Yasue; Mori, Katsuhiko; Mimori, Shigekazu; Ando, Makoto; Takahashi, Yukihiro; Nakanishi, Toshio
- Abstract
We report a case of a patient with severe heart failure after Fontan procedure in whom carvedilol was very effective. A 27-year-old man had intractable congestive heart failure due to severe ventricular dysfunction after Fontan operation. Central venous pressure was elevated to 29 mmHg. A right-to-left shunt was noted across a large collateral vessel between the innominate vein and the pulmonary vein. He was administered carvedilol (initial dose, 2 mg/day; maximum dose, 30 mg/day). Cardiac catheterization performed 1 year after carvedilol administration revealed a decrease in atrial pressure and improvement of ventricular function. He underwent a conversion operation to total cavopulmonary connection (TCPC) and ligation of a collateral vein communicating with the innominate and pulmonary veins. Carvedilol may be a legitimate treatment before TCPC conversion or heart transplantation for the high-risk group of patients with a failed Fontan circulation.
- Subjects
THERAPEUTICS; HEART failure; HEART diseases; CENTRAL venous pressure; VENOUS pressure; CARDIAC catheterization
- Publication
Pediatric Cardiology, 2006, Vol 27, Issue 4, p473
- ISSN
0172-0643
- Publication type
Article
- DOI
10.1007/s00246-006-1105-x