Related Experiment Video

Updated: Aug 10, 2025

Wireless Telemetry Device Implantation in a Fontan Ovine Model for Continuous and Long-Term Hemodynamic Monitoring
06:27

Wireless Telemetry Device Implantation in a Fontan Ovine Model for Continuous and Long-Term Hemodynamic Monitoring

Published on: May 2, 2025

238

Considerations for Advanced Heart Failure Consultation in Individuals With Fontan Circulation: Recommendations From

Adam M Lubert1, Ari Cedars2, Christopher S Almond3

  • 1Cincinnati Children's Hospital Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, OH (A.M.L., A.L., D.L.S.M., L.S.).

Circulation. Heart Failure
|February 14, 2023
PubMed

Insights

Individuals with Fontan circulation face risks of death from heart and non-heart issues. New guidelines from the ACTION Fontan Committee aim to improve timely referrals for advanced heart failure care, addressing a critical gap.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Individuals with Fontan circulation have increased risks of late mortality from cardiac and noncardiac causes.
  • Current referral indications for advanced heart failure care in this population are inconsistent, leading to delayed or missed consultations.
  • This can result in preventable deaths from Fontan circulation-related complications.

Purpose of the Study:

  • To establish clear, evidence-based guidelines for timely referral to advanced heart failure care for individuals with Fontan circulation.
  • To provide primary cardiologists with recommended thresholds for referral based on clinical Fontan circulatory dysfunction.
  • To reduce late mortality by ensuring appropriate and prompt access to advanced therapies.

Main Methods:

  • Development of consensus-based recommendations by the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) Fontan Committee.
  • Categorization of clinical Fontan circulatory dysfunction into four key areas: cardiac/systemic ventricular dysfunction, Fontan pathway dysfunction, lymphatic dysfunction, and extracardiac dysfunction.
  • Establishment of specific thresholds within these categories to guide advanced heart failure referral.

Main Results:

  • The ACTION Fontan Committee has proposed specific recommendations for advanced heart failure referral.
  • These recommendations are structured around four categories of Fontan circulatory dysfunction.
  • The guidelines aim to standardize and optimize the timing of consultations for advanced heart failure therapies.

Conclusions:

  • There is a critical need for standardized guidelines for advanced heart failure referral in individuals with Fontan circulation.
  • The ACTION Fontan Committee's recommendations provide a framework to guide cardiologists in identifying patients who require timely consultation.
  • Implementing these guidelines has the potential to improve outcomes and reduce mortality in this high-risk population.

Keywords:
Fontan procedurecongenital heart diseaseheart failuretransplantationventricular dysfunction

More Related Videos

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

6.6K
Implantation of Total Artificial Heart in Congenital Heart Disease07:27

Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

24.7K

Related Concept Videos

Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
21
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
19
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
130
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
24
Mitral Regurgitation IV: Nursing Management01:28

Mitral Regurgitation IV: Nursing Management

Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
67
Aortic Regurgitation IV: Nursing Management01:17

Aortic Regurgitation IV: Nursing Management

A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
36