Sizing Up Fontan Failure: Association with Increasing Weight in Adulthood

Area of Science:

• Cardiology
• Adult Congenital Heart Disease
• Metabolic Health

Background:

• Obesity is a growing concern in adults with Fontan palliation.
• The link between adult weight changes and Fontan failure is not well understood.

Purpose of the Study:

• To investigate the association between weight gain in adulthood and the development of Fontan failure.
• To test the hypothesis that increasing adult weight predicts Fontan failure.

Main Methods:

• Retrospective analysis of adult Fontan patients not in failure at first adult visit.
• Defined Fontan failure by adverse outcomes (death, transplant, complications, reduced VO2, diuretic use).
• Used survival analysis with Cox regression to assess weight change and Fontan failure risk.

Main Results:

• Patients who developed Fontan failure had significantly greater median weight gain (7.8 kg) than failure-free patients (4.9 kg).
• Increased adult weight was independently associated with a higher likelihood of developing Fontan failure (HR 1.36).

Conclusions:

• Adult weight gain is a significant risk factor for developing Fontan failure.
• Weight management in adulthood may be crucial for long-term outcomes in Fontan survivors.