Key result
Fontan circulation is linked to impaired vascular function and increased arterial stiffness across non-invasive assessments.
Non-invasive vascular assessments reveal significant endothelial dysfunction and altered hemodynamics in Fontan patients, offering potential tools for risk stratification and monitoring disease progression.
Non-invasive vascular assessments may aid risk stratification in Fontan patients; leaves open confirmation of prognostic value in longitudinal studies.
BACKGROUND: The Fontan procedure constitutes the definitive surgical strategy for complex congenital heart disease, establishing a circulation in which systemic venous blood is directed to the pulmonary arteries through a staged reconstruction that separates systemic and pulmonary venous return in the absence of a subpulmonary ventricle. This uniquely altered haemodynamic state exerts deleterious effects on endothelial function, thereby promoting progressive end-organ dysfunction and contributing substantially to the long-term morbidity observed in patients with Fontan circulation. ΜETHODS/RESULTS: Over recent decades, clinical research has employed a range of functional methods to assess macro- and microvascular function, as well as arterial stiffness. This review summarizes the available functional non-invasive techniques for evaluating vascular function in the Fontan circulation and discusses the existing evidence linking these vascular parameters to cardiac dysfunction, associated comorbidities, and clinical outcomes in this population. CONCLUSIONS: Functional non-invasive vascular assessment may provide valuable information for monitoring disease progression and risk stratification in Fontan circulation; however, further longitudinal studies are required to clarify its prognostic significance and potential clinical utility.
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Baroutidou et al. (2026) conducted a review in Fontan circulation. Non-invasive vascular assessment vs. Healthy controls was evaluated. Patients with Fontan circulation exhibit impaired macro- and microvascular function and increased arterial stiffness compared to controls, which can be quantified by non-invasive functional methods.
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