Acute Kidney Injury and Mid-term Outcomes After Extra-Cardiac Fontan Conversion

Pediatr Cardiol. 2024 Oct;45(7):1565-1572. doi: 10.1007/s00246-023-03220-y. Epub 2023 Jun 24.

Abstract

The aim of this study was to investigate the association of postoperative acute kidney injury and unplanned re-admission rate due to heart failure at 2 years follow-up in patients who had extra-cardiac Fontan conversion. This was a retrospective single-center study of patients who underwent conversion from classic Fontan to extra-cardiac Fontan between January 2014 and December 2021. Acute kidney injury was defined using the Kidney Disease Improving Global Outcomes criteria. A total of 47 patients underwent Fontan conversion. Acute kidney injury occurred in 22 patients (46.8%) and 5 patients with acute kidney injury needed renal replacement therapy. Unplanned re-admission rate at 2-year follow-up was significantly higher in patients with acute kidney injury even when renal function returned to baseline (8 [36.4%] vs. 3 [12.0%], p = 0.026 by the log-rank test). In conclusion, postoperative acute kidney injury after extra-cardiac Fontan conversion was associated with unplanned re-admission due to heart failure at 2-year follow-up even though renal function was recovered.

Keywords: Acute kidney injury; Conversion; Extra-cardiac conduit; Fontan; Renal replacement therapy; Total cavo-pulmonary connection.

MeSH terms

  • Acute Kidney Injury* / etiology
  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Fontan Procedure* / adverse effects
  • Heart Defects, Congenital* / surgery
  • Heart Failure / etiology
  • Humans
  • Male
  • Patient Readmission / statistics & numerical data
  • Postoperative Complications* / etiology
  • Retrospective Studies