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Related Experiment Videos

Cardiorespiratory response to exercise after the Fontan operation: a serial study

A Nir1, D J Driscoll, C D Mottram

  • 1Section of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota 55905.

Journal of the American College of Cardiology
|July 1, 1993
PubMed
Summary

Exercise tolerance in Fontan operation patients remained stable over 13 years. However, older patients experienced a greater decrease in heart rate, and a slight drop in blood oxygen saturation was observed.

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Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Physiology
  • Congenital Heart Disease

Background:

  • Previous studies indicated lower aerobic capacity in older Fontan patients.
  • Uncertainty existed whether this was due to aging or time post-Fontan operation.

Purpose of the Study:

  • To assess longitudinal changes in aerobic capacity after the Fontan operation.
  • To determine if aerobic capacity deteriorates over time in individual Fontan survivors.

Main Methods:

  • Longitudinal analysis of serial postoperative exercise studies in 25 Fontan patients (aged 3.8-39 years).
  • Exercise tests performed on average 2.2 and 5.9 years post-operation (range 1.8-13 years).
  • Evaluated exercise duration, oxygen uptake, hemodynamics, and arrhythmias.

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Main Results:

  • Exercise tolerance (duration, oxygen uptake) remained stable over time.
  • Systemic arterial oxygen saturation showed a significant decrease (p < 0.006).
  • Older patients exhibited a greater decline in resting and maximal heart rate (p < 0.05).

Conclusions:

  • Fontan patients demonstrated stable exercise tolerance up to 13 years post-operation.
  • Older patients showed accelerated heart rate decline, suggesting potential sinus node dysfunction.
  • Progressive decrease in oxygen saturation may indicate developing pulmonary arteriovenous fistulas or altered coronary sinus positioning.