Related Experiment Videos
Influence of ventricular morphology on outcome after the Fontan procedure
P R Julsrud1, T J Weigel, J A Van Son
1Department of Diagnostic Radiology, Mayo Clinic, Rochester MN 55905, USA.
Insights
Ventricular morphology impacts early survival after the modified Fontan procedure for congenital heart defects. Left ventricular morphology offers better early outcomes than right ventricular morphology, but doesn't affect long-term mortality.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- The modified Fontan procedure is a key treatment for complex congenital heart defects.
- Identifying mortality risk factors is crucial for patient selection and optimizing outcomes.
- The role of ventricular morphology as a risk factor remains debated.
Purpose of the Study:
- To investigate the impact of ventricular morphology on early and long-term survival after the Fontan procedure.
- To correlate ventricular morphology with outcomes such as Fontan takedown or cardiac transplantation.
Main Methods:
- Retrospective analysis of the first 500 patients undergoing the modified Fontan procedure.
- Assessment of survival free of Fontan takedown or cardiac transplantation.
- Correlation of survival data with ventricular morphology evaluated by angiography.
- Application of univariate and multivariate statistical analyses.
Main Results:
- Ventricular morphology was a significant predictor of early survival free of Fontan takedown or cardiac transplantation.
- Patients with left ventricular morphology demonstrated better early survival compared to those with right ventricular morphology.
- No statistical evidence linked ventricular morphology to mortality risk in patients surviving beyond 6 months post-procedure.
Conclusions:
- Ventricular morphology is a critical factor influencing early survival outcomes in patients undergoing the Fontan procedure.
- Left ventricular morphology is associated with improved early outcomes, highlighting its importance in surgical planning.
- Ventricular morphology does not appear to be a risk factor for long-term mortality in survivors of the Fontan procedure.
Abstract:
The modified Fontan procedure has gained wide acceptance in the treatment of various congenital heart defects. Determination of risk factors for mortality remains an important issue for optimizing patient selection for the Fontan procedure. Conflicting results have been reported about whether ventricular morphology is a risk factor in these patients. Survival free of Fontan takedown or cardiac transplantation was assessed in the first 500 patients undergoing the Fontan procedure at our institution. This survival was correlated with ventricular morphology as evaluated by angiography. Both multivariate and univariate analyses indicated ventricular morphology was predictive of early survival free of Fontan takedown or cardiac transplantation following the procedure. However, there was no statistical evidence for ventricular morphology being a risk factor for mortality in patients alive 6 months after the procedure. Ventricular morphology is a risk factor for early survival in patients undergoing a Fontan procedure, with left ventricular morphology associated with a better early survival than right ventricular morphology.