Functional capacity following univentricular repair--midterm outcome

Area of Science:

• Pediatric Cardiology
• Congenital Heart Disease
• Surgical Outcomes

Background:

• The Fontan procedure and Glenn operation are palliative surgeries for complex congenital heart defects.
• Functional capacity after these surgeries is crucial for long-term outcomes.
• Limited data exists comparing functional capacity between Fontan and Glenn operations.

Purpose of the Study:

• To compare midterm submaximal exercise capacity in children following Fontan procedure versus Glenn operation.
• To identify factors associated with better exercise capacity in these pediatric populations.

Main Methods:

• Fifty-seven children (aged 5-18) who underwent either Glenn (n=44) or Fontan (n=13) operations were assessed.
• Standard 6-minute walk tests were employed to evaluate functional capacity.

Main Results:

• No significant difference in 6-minute walk distance or postexercise heart rate was observed between the Fontan and Glenn groups.
• Glenn patients under 10 had lower baseline SpO2 compared to Fontan patients.
• Lower resting heart rate, higher resting SpO2, and younger age at operation were significant determinants of longer walk distance and higher postexercise SpO2.

Conclusions:

• Fontan circulation did not demonstrate superior midterm submaximal exercise capacity compared to Glenn physiology.
• Resting heart rate, resting SpO2, and age at operation are key factors influencing exercise capacity post-Fontan or Glenn surgery.