The long-term effect of the Fontan fenestration on clinical outcomes: A FORCE registry study
Main findingResult — go to the resultHazard ratio 1.70 95% CI 1.09–2.64Authors' conclusion
Open fenestration is associated with adverse outcomes when adjusted for clinical characteristics. The association disappeared when additionally adjusting for CMR variables.
Study context
- Population
- Fontan patients with post-Fontan CMR (FORCE registry); median age at CMR 14.3 years
- Participants
- 2,923 patients
- Exposure
- Open fenestration vs nonfenestrated Fontan, spontaneous closure and device closure
- Outcome
- Time from CMR to earliest of death, listing for or receiving heart transplant, plastic bronchitis or protein-losing enteropathy
Methodological detailsCox proportional hazard models adjusted for clinical and CMR characteristics
- Cox proportional hazard models adjusted for clinical and CMR characteristics
Main finding
As reported in the abstract
Hazard ratio
1.70
95% CI 1.09–2.64
P = 0.02
Open fenestrationvs nonfenestrated Fontan, spontaneous closure and device closure
HR 1.70 (95% CI 1.09–2.64); P = 0.02
Observational data: associations, not effects.
Further findings
SVEDVi and primary outcome (CMR-adjusted model)
- Every 10 mL/m² increase in SVEDVi associated with 5% increase in hazard of clinical outcomes
- P < 0.0001
Original publication
The long-term effect of the Fontan fenestration on clinical outcomes: A FORCE registry study. Am Heart J. Published 14 June 2025. doi:10.
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