Why the study?
Does the Fontan operation improve clinical and social outcomes in adult patients with single ventricular physiology compared to no Fontan operation?
Does the Fontan operation improve clinical and social outcomes in adult patients with single ventricular physiology compared to no Fontan operation?
Adults with single ventricular physiology face high rates of cardiovascular events and poor social outcomes regardless of whether they underwent a Fontan operation.
Fontan does not reduce events or improve social outcomes; leaves open need for adjunctive strategies in single-ventricle adults.
BACKGROUND: This study was performed to clarify the present global clinical status, including medication(s) and social abilities, of adult patients with single ventricular physiology (SVP). METHODS AND RESULTS: Clinical charts were retrospectively reviewed to evaluate the global clinical status, including functional capacity, medication(s), complications, and social activities of 68 adult patients with SVP aged 20-53 years (41 males); 50 had undergone the Fontan operation and they were divided into the young adult (25 patients) and adult Fontan groups. The others were cyanotic patients without the Fontan operation (non-Fontan group). Although the Fontan groups showed better functional capacity, higher arterial oxygen saturation and brain natriuretic peptide levels, and a better renal function, there was no difference in the cardiovascular events during follow-up between the 3 groups. The most frequent complication was arrhythmia without a significant group difference, although the non-Fontan group showed a high percentage of heart failure. Only 41 patients (60%) had a job and 8 (12%) were married. CONCLUSIONS: Although the Fontan groups had favorable pathophysiological conditions, the high rate of cardiovascular events, as well as unsatisfactory social situations, indicate the importance of meticulous life-long management of patients with SVP, regardless of the type of surgical intervention.
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Motoki et al. (2009) studied this question.
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