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Unplanned Readmissions due to Pleural Effusion Following the Fontan Operation
Jean M Meneses1,2, Mohan Pankhuri1,2, Jake Beerel1,3
1Penn State Hershey Pediatric Cardiovascular Research Center, Penn State College of Medicine, Penn State Health Children's Hospital, Hershey, PA, USA.
World Journal for Pediatric & Congenital Heart Surgery
|April 7, 2026
Summary
Older age at Fontan, chylothorax, and absent fenestration are key risk factors for readmission after Fontan surgery due to pleural effusion. Optimizing care may reduce these unplanned hospitalizations.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Surgery
Background:
- The Fontan operation is a critical palliative procedure for single-ventricle patients.
- Postoperative pleural effusions are a common complication, leading to increased morbidity and hospitalizations.
Purpose of the Study:
- To identify the incidence and risk factors associated with unplanned readmissions for post-Fontan pleural effusion.
Main Methods:
- A retrospective case-control study analyzed single-ventricle patients who underwent the Fontan procedure between 2012-2023.
- Factors analyzed included demographics, pre-Fontan hemodynamics, surgical details, and post-discharge outcomes.
Main Results:
- 14.7% of patients were readmitted for pleural effusion.
- Risk factors for readmission included older age at Fontan, chylothorax, absent/restrictive fenestration at discharge, and presence of effusion at the first postoperative visit.
- Readmitted patients required higher diuretic doses.
Conclusions:
- Older age at Fontan, chylothorax, absent/restrictive fenestration, and early postoperative effusion are significant risk factors for readmission.
- Strategies like earlier Fontan timing, optimized diuretic management, and ensuring fenestration patency may decrease readmissions.
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