Evidence mapPaperPMID 42489389Full record

ReviewJACC. Advances2026

Contemporary Management and Future Directions of Adults Living With a Fontan Circulation.

Jasmine Grewal, Giulia Pula, Rachel M Wald, Rachael Cordina, Alexander Van De Bruaene, Luke J Burchill, Paul Khairy, Jamil Aboulhosn, D Scott Lim, Nadine A Kasparian and 2 more

Abstract readReview
In one paragraph

Review in JACC. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jasmine GrewalUniversity of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada. Electronic address: jasmine.grewal@phc.ca.
Giulia PulaUniversity of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Rachel M WaldToronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, Toronto, Ontario, Canada.
Rachael CordinaDepartment of Cardiology Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Alexander Van De BruaeneDivision of Adult Congenital Heart Disease, University Hospitals Leuven, Leuven, Belgium.
Luke J BurchillDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Paul KhairyMontreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
Jamil AboulhosnUCLA Department of Pediatrics David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
D Scott LimUniversity of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Nadine A KasparianHeart and Mind Wellbeing Center, Heart Institute and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital, Cincinnati, Ohio, USA.
Yves d'UdekemPediatric Cardiothoracic Surgery, Children's National Hospital, Washington, District of Columbia, USA.
Alexander R OpotowskyThe Cincinnati Adult Congenital Heart Disease Program, Heart Institute, Cincinnati Children's Hospital, Cincinnati, Ohio, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

As 30-year survival after Fontan nears 90%, clinicians increasingly encounter Fontan circulatory failure. This panel introduces a pragmatic Fontan circulation function grading framework with red-flag triggers to prompt timely reassessment. Pathophysiology and management of key drivers and consequences of Fontan circulatory failure are outlined, including ventricular dysfunction/heart failure, arrhythmias, pulmonary vascular remodeling, lymphatic dysfunction, thromboembolism, and pathway obstruction. Considerations for pharmacologic, catheter-based, surgical, and transplant strategies are outlined. Comprehensive care is summarized across nutrition, endocrine-metabolic and bone health, mental health and neurocognition, and sexual and reproductive health, including pregnancy risk. Future directions emphasize multicenter registries and learning-health systems, standardized outcome measures, invasive exercise hemodynamics, advanced imaging and biomarker programs. We highlight emerging therapies, such as image-guided lymphatic interventions, cavopulmonary assist devices, optimized heart ± liver transplantation, and targeted/repurposed pharmacotherapy.

Indexed as

complicationsfailureFontangradingrisk

Identifiers

PMID42489389
PMCPMC13400117

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.