Key result
Fontan surgery demonstrated overall survival rates of 91.7%, 87.1%, and 74.4% at 10, 20, and 30 years, respectively, with heterotaxy syndrome and AP-type surgery identified as poor prognostic factors.
Why the study?
Outcomes of Fontan surgery in the Republic of Korea needed analysis, as few studies were available from Asian countries.
Observational (n=1,732)
Yes
Answers are grounded in this paper and cite their sources.
In a large Asian cohort with a high prevalence of heterotaxy syndrome, Fontan surgery demonstrated a 30-year survival rate of 74.4%, with heterotaxy, atriopulmonary-type surgery, and elevated pre-operative pulmonary artery pressure identified as key risk factors for mortality.
BACKGROUND AND OBJECTIVES: This study aimed to analyze the outcomes of Fontan surgery in the Republic of Korea, as there were only a few studies from Asian countries. METHODS: The medical records of 1,732 patients who underwent Fontan surgery in 10 cardiac centers were reviewed. RESULTS: Among them, 1,040 (58.8%) were men. The mean age at Fontan surgery was 4.3±4.2 years, and 395 (22.8%) patients presented with heterotaxy syndrome. According to the types of Fontan surgery, 157 patients underwent atriopulmonary (AP) type; 303, lateral tunnel (LT) type; and 1,266, extracardiac conduit (ECC) type. The overall survival rates were 91.7%, 87.1%, and 74.4% at 10, 20, and 30 years, respectively. The risk factors of early mortality were male, heterotaxy syndrome, AP-type Fontan surgery, high mean pulmonary artery pressure (mPAP) in pre-Fontan cardiac catheterization, and early Fontan surgery year. The risk factors of late mortality were heterotaxy syndrome, genetic disorder, significant atrioventricular valve regurgitation (AVVR) before Fontan surgery, high mPAP in pre-Fontan cardiac catheterization, and no fenestration. CONCLUSIONS: In Asian population with a high incidence of heterotaxy syndrome, the heterotaxy syndrome was identified as the poor prognostic factors for Fontan surgery. The preoperative low mPAP and less AVVR are associated with better early and long-term outcomes of Fontan surgery.
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Lee et al. (2024) conducted an observational in Congenital heart disease requiring Fontan surgery (n=1,732). Fontan surgery was evaluated on Overall survival at 10 years. Fontan surgery demonstrated overall survival rates of 91.7%, 87.1%, and 74.4% at 10, 20, and 30 years, respectively, with heterotaxy syndrome and AP-type surgery identified as poor prognostic factors.
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