What is the clinical evidence from this study?

Study design: Cohort. Population: Functional single ventricle physiology (Fontan patients) (n=1631). Intervention: Systemic right ventricular morphology vs. Systemic left ventricular morphology. Primary outcome: Death or heart transplantation (HR 1.699, 95% CI 1.130-2.554, p=0.011).

What question did this study set out to answer?

This study aims to determine how different types of anatomical ventricles affect long-term outcomes in Fontan patients over 30 years.

June 12, 2026Structural and Congenital Heart Disease0 citationsOpen Access

Anatomical Ventricular Type Determines 30-Years Outcomes in Fontan patients: Insights from National Korean Registry

JBJae Suk BaekPediatric / Congenital Cardiology SKS H KimUniversity of Ulsan SLSang-Yun LeeUniversity of Ulsan

Key Result

Systemic right ventricular morphology was associated with a significantly higher risk of death or heart transplantation compared with systemic left ventricular morphology (HR 1.699).

Key Points

This study aims to determine how different types of anatomical ventricles affect long-term outcomes in Fontan patients over 30 years.
Analyzed data from the National Korean Registry of Fontan patients.
Evaluated the association between ventricular morphology and long-term outcomes, adjusting for AVVR.
Patients with systemic right ventricular morphology had significantly worse outcomes at 30 years (e.g., higher rates of complications).
Analysis revealed a clear link between specific anatomical types and prognosis, with a notable impact from AVVR.

Study Design

Type

Cohort (n=1,631)

Multicenter

Yes

Structured PICO

Does systemic right ventricular morphology or two adequately sized ventricles worsen long-term outcomes compared to systemic left ventricular morphology in Fontan survivors?

Population

1,631 patients who survived the Fontan procedure, with a mean age at surgery of 4.3 years, followed for a median of 13.2 years to evaluate long-term outcomes based on ventricular morphology.

Exposure

Systemic right ventricular morphology (n=584) or two adequately sized ventricles (2V) (n=417)

Comparator

Systemic left ventricular morphology (n=630)

Outcome

Death or heart transplantation, and Fontan failure (composite of death, heart transplantation, Fontan takedown or conversion, protein-losing enteropathy, plastic bronchitis, or New York Heart Association class III/IV)composite

In Fontan survivors, systemic right ventricular morphology is independently associated with a higher risk of long-term mortality and Fontan failure compared to systemic left ventricular morphology, even after adjusting for atrioventricular valve regurgitation.

Main Result

Hazard Ratio: 1.699 (95% CI 1.13–2.554)

p-value: p=0.011

Limitations

Retrospective design and reliance on registry data
Ventricular morphology classification was based on a registry-recorded variable reflecting institutional echocardiographic and surgical assessments, introducing inter-center variability
Variability in surgical techniques, perioperative care, and follow-up protocols across multiple centers
Effects of ventricular morphology could not be clearly distinguished from those of atrioventricular valve morphology due to small subgroup sizes and inherent distribution of valve types

Abstract

Background: Systemic right ventricular morphology is associated with poor Fontan outcomes, but its independent effect remains uncertain due to confounding by atrioventricular valve regurgitation (AVVR). The prognostic role of... | Find, read and cite all the research you need on Tech Science Press

Ask AI

Helpful

Bookmark

View Full Paper