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Updated: Dec 30, 2025
Wireless Telemetry Device Implantation in a Fontan Ovine Model for Continuous and Long-Term Hemodynamic Monitoring
Published on: May 2, 2025
Effect of Fenestration on Fontan Procedure Outcomes: A Meta-Analysis and Review
Ismail Bouhout1, Walid Ben-Ali1, Dori Khalaf1
1Division of Cardiac Surgery, CHU-ME Sainte Justine, University of Montréal, Montréal, Quebec, Canada; Montréal Heart Institute, University of Montréal, Montréal, Quebec, Canada.
Background:
Many studies investigating fenestration in the context of Fontan procedure have been showing controversial results when it comes to whether this procedure truly improves the Surgical outcomes. The aim of this meta-analysis was to compare the early outcomes of a fenestrated (F) vs a nonfenestrated (NF) Fontan procedure.
Methods:
The PubMed, EMBASE, and Cochrane Library databases were searched for articles measuring the outcomes of an F vs an NF Fontan.
Results:
A total of 19 studies were selected with a total of 4806 patients (F. 2727; NF. 2079). There was no difference in the risk of Fontan failure between both groups (odds ratio [OR], 0.95 [95% confidence interval [CI], 0.57, 1.56]; P = .83). The F group had a significantly lower need for pleural drainage (OR, 0.59 [95% CI, 0.37, 0.94]; P = .03), a lower pulmonary artery pressure (mean difference, -0.99 mm Hg [95% CI, -1.68, 0.30 mm Hg]; P = .005), and a lower oxygen saturation (mean difference, -3.07% [95% CI, -4.30%, -1.85%]; P < .001) than the NF group. There was no significant difference in the stroke occurrence between the 2 groups (OR, 1.32 [95% CI, 0.40, 4.36]; P = .65).
Conclusions:
The Fontan fenestration effectively reduced the pulmonary pressure and the need for prolonged pleural drainage. However, the risks of Fontan failure, early death, and longer hospital stay were not modified.
