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Fontan "Ten Commandments" revisited and revised.

Herbert J Stern

Pediatric Cardiology

|October 21, 2010

Summary

This summary is machine-generated.

Choussat's "Ten Commandments" for Fontan candidates need updating. Achieving perfection is now the sole criterion for optimal long-term survival in Fontan patients.

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Area of Science:

Cardiology
Pediatric Cardiology
Congenital Heart Disease

Background:

Choussat's
Ten Commandments
established criteria for ideal Fontan candidates in 1977.
These guidelines aimed to optimize outcomes for patients with single ventricle physiology.

Discussion:

Historical analysis reveals that strict adherence to all original commandments does not guarantee excellent long-term survival.
The evolving understanding of Fontan physiology necessitates a re-evaluation of selection criteria.
Focusing solely on perfection addresses the complexity of achieving superior long-term outcomes.

Key Insights:

The original Fontan candidate selection criteria require modification.
Long-term survival improvement should be the primary endpoint for evaluating Fontan candidates.
A singular, stringent criterion of "perfection" is proposed to encompass all necessary factors for optimal Fontan outcomes.

Outlook:

Future research should validate the proposed "perfection" criterion.
Refined patient selection may lead to improved long-term survival rates post-Fontan procedure.
This updated approach could enhance the management of complex congenital heart disease.