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Cardiac output drop reflects circulatory attrition after Fontan completion: serial cardiac magnetic resonance study.
Eur Heart J Imaging Methods Pract
September 2023
Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Aims: Cardiac magnetic resonance (CMR) imaging is a main diagnostic tool in the follow-up of Fontan patients. However, the value of serial CMR for the evaluation of Fontan attrition is unknown. The aim of this prospective study of serial CMR is to describe the analysis of time-dependent evolution of blood flow distribution, ventricular volumes, and function in patients after Fontan completion.
View Article and Find Full Text PDFAttrition Before Fontan vs Creating a Bad Fontan: The Dilemma.
Ann Thorac Surg
October 2023
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
Impact of Ventricular Dysfunction and Atrioventricular Valve Regurgitation on Pre-Fontan Attrition.
Ann Thorac Surg
October 2023
Division of Pediatric Cardiology, Department of Pediatrics, Larner College of Medicine at University of Vermont, Burlington, Vermont.
Background: There is a significant incidence of pre-Fontan attrition-defined as failure to undergo Fontan completion-after superior cavopulmonary connection. This study investigated the impact of at least moderate ventricular dysfunction (VD) and atrioventricular valve regurgitation (AVVR) on pre-Fontan attrition.
Methods: This single-center retrospective cohort study included all infants who underwent Norwood palliation from 2008 to 2020 and subsequently underwent superior cavopulmonary connection.
Fontan failure: phenotypes, evaluation, management, and future directions.
Cardiol Young
October 2022
Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India.
Objectives: Management of "failing" and "failed" Fontan circulation, particularly the indications, timing, and type of re-intervention, currently remains nebulous. Factors contributing to pathogenesis and mortality following Fontan procedure differ between children and adults.
Methods: Since organ systems in individual patients are affected differently, we searched the extant literature for a "failing" and "failed" Fontan reviewing the clinical phenotypes, diagnostic modalities, pharmacological, non-pharmacological, and surgical techniques employed, and their outcomes.
Surgical management of failing Fontan circulation: results from 30 cases with 285 patient-years follow-up.
Eur J Cardiothorac Surg
January 2022
Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, Padova, Italy.
Objectives: Fontan patients are known to suffer from clinical attrition over the years, which has been characterized as Fontan failure. We sought to evaluate the clinical outcomes of such Fontan patients undergoing surgical management in a 25-year, single-centre experience.
Methods: A retrospective single-centre analysis of patients undergoing surgical treatment for failing Fontan between 1995 and 2020, including any reoperations when ventricular function was preserved, or a heart transplant (HTx), when ventricular contractility was impaired.
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