Congenital: Fontan
Long-term outcomes of warfarin versus aspirin after Fontan surgery
Because of the nature of the Fontan physiology, patients are at an increased risk of thromboembolic complications. As such, warfarin or aspirin is generally prescribed lifelong for thromboprophylaxis. This study aimed to compare long-term rates of cerebrovascular injury, thrombosis, bleeding, bone mineral density, and quality of life in people living with Fontan circulation receiving warfarin compared with aspirin.Long-term outcomes following Fontan takedown in Australia and New Zealand
Fontan takedown remains an option for the management of Fontan failure. We sought to evaluate early and late outcomes after Fontan takedown.Protein-losing enteropathy and plastic bronchitis after the Fontan procedure
Protein losing enteropathy and plastic bronchitis are severe complications in Fontan circulation, with 5-year survival ranging from 46% to 88%. We report risk factors and outcomes of protein losing enteropathy and plastic bronchitis in patients undergoing the Fontan.Commentary: Moderate atrioventricular valve regurgitation may be too much to bear for a single ventricle
In their editorial review in this issue of the Journal, Stephens and Dearani1 comment on the results of our retrospective series2 that assessed the incidence and impact of atrioventricular regurgitation in patients who had survived the Fontan operation. In our experience, more than half of the common atrioventricular valves and tricuspid valves were regurgitant or necessitated intervention before patients reached the age of 25 years (Figure 1).2 The existence of even moderate regurgitation was enough to more than double a patient's risk of circulatory failure, which for most meant death or transplantation.
