Congenital heart diseaseCohort study
Morbidity and mortality in adults with a Fontan circulation beyond the fourth decade of life
- Retrospective cohort study
- multicentre
- 3 European specialist centres
- consecutive patients
Authors' conclusion
Our study highlights the significant morbidity and mortality in older adults with a Fontan-type circulation
Study context
- Population
- Adults above 35 years with a Fontan-type circulation
- Participants
- 115 participants
- Outcome
- Late outcomes: morbidity and mortality
- Follow-up
- Median 5.0 (2.4-10.3) years
Main finding
As reported in the abstract
Death and transplantation referral
- Died (mainly from HF, 84.2%)
- 19 (16.5%)
- Referred for transplantation assessment
- 15 (13.0%)
- At least one arrhythmia
- 76 (66.1%)
- Protein-losing enteropathy
- 8 (7.0%)
- Repeat surgery or intervention
- One-third
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Univariable predictors of death or transplantation — Lower serum albumin level · per g/L decrease | 1.09 (1.04–1.15) | P = 0.0009 | |
| 0.512Hazard ratio (log scale) |
Univariable predictors of death or transplantation
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| Prior heart failure admission | 4.28 (1.75–10.44) | P = 0.001 | |
| Prior atrial tachycardia or flutter | 3.02 (1.23–7.38) | P = 0.02 | |
| Baseline pulmonary vasodilator therapy | 8.59 (1.05–70.13) | P = 0.04 | |
| 0.050.21520Hazard ratio (log scale) |
Univariable predictors of death or transplantation
- Lower serum albumin and prior atrial tachycardia or flutter remained significant on bivariable analysis
Original publication
Morbidity and mortality in adults with a Fontan circulation beyond the fourth decade of life. Eur J Prev Cardiol. Published 2 February 2024. doi:10.1093/eurjpc/zwae031
Summarised from the published abstract; every number is checked against it