Related Experiment Video
Updated: Jan 15, 2026
06:29
Wireless Telemetry Device Implantation in a Fontan Ovine Model for Continuous and Long-Term Hemodynamic Monitoring
Published on: May 2, 2025
710
Long-Term Outcomes After Fontan Conversion Operation: A Comparative Analysis Based on Type of Fontan Connection
Amr Moustafa1, Zeyad Kholeif1, William R Miranda1
1Department of Cardiovascular Medicine (A.M., Z.K., W.R.M., H.M.C., A.C.E.), Mayo Clinic, Rochester, MN.
Circulation. Heart Failure
|October 13, 2025
Summary
Fontan conversion (FC) does not improve long-term survival in adults with Fontan palliation. The duration of Fontan physiology, not the connection type, impacts outcomes, with older age and comorbidities being key risk factors.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Adult Congenital Heart Disease
Background:
- Fontan conversion (FC) is linked to reduced atrial arrhythmias and thromboembolism.
- Its effect on long-term survival after Fontan palliation remains unclear.
Purpose of the Study:
- To evaluate the impact of Fontan conversion on transplant-free survival in adults.
Main Methods:
- Compared transplant-free survival in 534 adults with Fontan palliation across three groups: atriopulmonary Fontan, Fontan conversion to total cavopulmonary connection (FC-TCPC), and initial TCPC.
- Utilized Cox regression analysis to assess the risk of death or transplant.
Main Results:
- No significant difference in 15-year death/transplant incidence between FC-TCPC (42%) and TCPC (47%) groups.
- Multivariable analysis identified older age, hepatorenal dysfunction, heart failure, and higher Fontan pressures as risk factors, not FC or connection type.
- Comorbidities increased with age, suggesting duration of Fontan physiology is critical.
Conclusions:
- Fontan conversion may not be optimal for adults with Fontan failure due to high operative mortality.
- The duration of Fontan physiology, rather than the specific connection type, is the primary determinant of long-term outcomes.
