ArticleJournal of thoracic disease2025
Longitudinal changes in ventricular function and atrioventricular valve failure following cardiac morphology after Fontan procedure.
Article in Journal of thoracic disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Characteristics Associated with Poor Long-Term Outcomes in Patients with Fontan Palliation: A Case-Control Study.Pediatric cardiology · 2026Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Ventricular dysfunction and atrioventricular valve (AVV) failure in Fontan patients are associated with adverse long-term outcomes; however, data on longitudinal changes and their relationship with morphology are lacking. This study aimed to describe longitudinal changes in ventricular function and AVV regurgitation and to determine the risk factors in Fontan patients who develop ventricular dysfunction and AVV failure. Methods: We retrospectively reviewed echocardiographic images from patients who underwent Fontan procedure from 1984 to 2015. Mixed-effects model fits a unique linear regression line using serial ejection fraction (EF) and AVV regurgitation. Multivariate logistic regression was performed to find morphologic risk factors for ventricular dysfunction and AVV failure. Results: Out of 174 patients who underwent 3,203 echocardiograms, a significant 6.2% decrease in EF was observed (P<0.001) over a median follow-up of 17.6 years (interquartile range, 15.3-19.2 years) post Fontan procedure. Higher prevalence of ventricular dysfunction (EF <50%) was noted in dominant right ventricle (RV) and two-ventricular (2V) morphologies compared to left ventricle (LV) (P<0.001). AVV failure was more common in RV and 2V morphologies as well (P<0.001). Notably, patients with tricuspid valve (TV) and common AVV exhibited the most pronounced AVV failure (P<0.001). In multivariate analysis, RV, TV and common AVV were correlated with AVV failure (hazard ratio 5.37, 8.24 and 5.43, respectively). Conclusions: Fontan patients with long-term follow-up showed a progressive decline in ventricular and AVV function. Dominant RV, TV and common AVV were prognostic factors for predicting AVV failure. Further studies are warranted to explore and validate these findings.
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