Key result
Extracardiac conduit size shows no link to long-term adverse events after Fontan completion.
Why the study?
The impact of extracardiac conduit size and risk factors on long-term outcomes following the contemporary Fontan procedure remained unclear.
Does extracardiac conduit size, procedure type, or fenestration affect long-term outcomes in patients undergoing the contemporary Fontan procedure?
Cohort (n=813)
Yes
Does extracardiac conduit size, procedure type, or fenestration affect long-term outcomes in patients undergoing the contemporary Fontan procedure?
In patients undergoing the Fontan procedure, extracardiac conduit size does not appear to affect long-term clinical outcomes, whereas lateral tunnel is associated with more sustained SVT and fenestration may increase late adverse events.
May warrant conduit size consideration in Fontan planning; leaves open optimal thresholds pending prospective data.
Objective: We sought to review the impact of extracardiac conduit size and risk factors on the long-term outcomes of the contemporary Fontan procedure: lateral tunnel and extracardiac conduits. Methods: Data were collected from a binational registry. Composite outcome of late adverse events included death, transplant, Fontan failure, supraventricular tachycardia (SVT), thromboembolism, or pacemaker implantation. Results: = .025, respectively). Landmark analysis was performed from 16 years of age in patients without Fontan failure (n = 813). Transplant-free survival and freedom from Fontan failure were 87% (95% CI, 81%-91%) and 80% (95% CI, 72%-85%) at 20 years from this time point, respectively. Conclusions: Despite recent suggestions, extracardiac conduit sizes do not appear to affect long-term clinical outcomes. Patients with lateral tunnel have a greater incidence of sustained SVT, and Fontan fenestration may increase incidence of late adverse events.
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Daley et al. (2026) conducted a cohort in Fontan procedure (n=813). Extracardiac conduit size and lateral tunnel was evaluated on Composite outcome of late adverse events (death, transplant, Fontan failure, SVT, thromboembolism, or pacemaker implantation).
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