Influence of ventricular morphology on outcome after the Fontan procedure

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.