ABSTRACT Similar to other cardiovascular conditions, accurate cardiac output (CO) assessment in Fontan patients is critical for evaluation of hemodynamic state. However, traditional methodologies, including the Fick principle, thermodilution, Doppler echocardiography, and cardiac magnetic resonance imaging face substantial limitations due to Fontan-specific anatomy and physiology. Impedance cardiography-based technologies offer a noninvasive alternative, yet they remain undervalidated in this unique population. This review highlights the challenges of established methods and emphasizes the need to explore, refine, and validate impedance cardiography-based CO monitoring across pediatric and adult Fontan patients.
Shah et al. (2026) studied this question.