What does this research mean for the field?

In adolescents and adults with tricuspid atresia, the Fontan operation is associated with better functional ability and exercise capacity compared to palliative shunts or no surgery, despite similar left ventricular ejection fractions and age-related arrhythmia frequencies. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the current clinical status, functional capacity, and late complications in adolescent and adult patients with tricuspid atresia and normally related great arteries.

December 1, 1986HeartOpen Access

Tricuspid atresia in adolescents and adults: current state and late complications.

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Why the study?

Does Fontan operation improve ability to lead a normal life in adolescents and adults with tricuspid atresia compared to palliative shunts or no surgery?

Population

29 patients aged 15-35 years (mean 23) with tricuspid atresia and normally related great arteries

Comparison

Fontan operation vs Palliative shunts or no surgery

Design

Cohort

Authors

CWCarole A. WarnesAdult Congenital Heart Disease JSJane SomervilleUniversità Cattolica del Sacro Cuore

Discussion

Member takes

Implication

May favor Fontan for better functional status in tricuspid atresia; hypothesis-generating and leaves causal benefit open.

Key Points

To evaluate the current clinical status, functional capacity, and late complications in adolescent and adult patients with tricuspid atresia and normally related great arteries.
Studied 29 patients aged 15–35 years (mean 23) with tricuspid atresia and normally related great arteries, of whom 20 were alive.
Compared surviving patients who underwent the Fontan operation (Group 1, n=10) with those managed by palliative shunts (n=9) or no surgery (n=1) (Group 2, n=10).
Assessed functional status using an ability index, exercise capacity, left ventricular ejection fraction via radionuclide angiography, and arrhythmia prevalence.
Patients who underwent the Fontan operation exhibited a better ability index, superior exercise capacity, and fewer social and extracardiac complications than palliated or unoperated controls.
Mean left ventricular ejection fraction measured by radionuclide angiography was equivalent between the Fontan and non-Fontan groups.
Arrhythmias occurred with equal frequency in both groups, displaying an age-related pattern that developed independently of left ventricular function.

Structured PICO

Does Fontan operation improve ability to lead a normal life in adolescents and adults with tricuspid atresia compared to palliative shunts or no surgery?

Population

29 patients aged 15-35 years (mean 23) with tricuspid atresia and normally related great arteries

Intervention

Fontan operation

Comparator

Palliative shunts or no surgery

Outcome

Ability to lead a normal life (ability index)patient reported

Cite This Study

Warnes et al. (1986) studied this question.

synapsesocial.com/papers/6a1c61cd1567d2fc4d600321 https://doi.org/10.1136/hrt.56.6.535

Topics

Valvular heart disease

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Tricuspid atresia in adolescents and adults: current state and late complications.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Tricuspid atresia in adolescents and adults: current state and late complications.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider