Cardiovascular Outcomes in Fontan Patients With Right vs Left Univentricular Morphology
Nabil Dib, Marie Chaix, Michelle Samuel, Sewanou Hermann Honfo, Robert M Hamilton, Jamil Aboulhosn, Craig S. Broberg, Scott Cohen, Stephen L. Cook, Annie Dore, Susan M Jameson, Anne Fournier, Reda Ibrahim, Joseph Kay, François‐Pierre Mongeon, Alexander R. Opotowsky, Ali N. Zaidi, Nancy Poirier, Paul Khairy
Abstract
Background: There is a paucity of data on long-term outcomes after Fontan palliation in patients with a dominant morphological univentricular right (uRV) vs left (uLV) ventricle. Objectives: The purpose of this study was to compare the incidence of atrial arrhythmias, thromboembolic events, cardiac transplantation, and death following Fontan palliation in patients with uRV vs uLV. Methods: The Alliance for Adult Research in Congenital Cardiology conducted a multicenter retrospective cohort study on patients with total cavopulmonary connection Fontan palliation across 12 centers in North America. All components of the composite outcome, that is, atrial arrhythmias, thromboembolic events, cardiac transplantation, and death, were reviewed and classified by a blinded adjudicating committee. Time-to-event analyses were performed that accounted for competing risks. Results: = 0.131). Conclusions: Fontan patients with uRV vs uLV morphology have a higher incidence of adverse cardiovascular events, including atrial arrhythmia, cardiac transplantation, and all-cause mortality.