Long-term follow-up of Fontan completion in adults and adolescents

Fuchigami, Tai; Nagashima, Mitsugi; Hiramatsu, Takeshi; Matsumura, Goki; Tateishi, Minori; Masuda, Noriyasu; Yamazaki, Kenji

doi:10.1111/jocs.13157

Cited by 8 publications

(7 citation statements)

References 25 publications

(23 reference statements)

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“…This case also exemplifies the need for close follow‐up in those adults who have undergone surgery for congenital lesions as children . It also demonstrates that patients with congenital lesions may also go on to acquire diseases of the aorta and coronary arteries that will need surgery as adults …”

Section: Introductionmentioning

confidence: 75%

Root aneurysm following aortic valve replacement 20 years after an arterial switch operation

et al. 2017

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Late development of annuloaortic ectasia (AAE) and progression of aortic regurgitation (AR) are widely recognized outcomes following an arterial switch operation (ASO). We treated a 29-year-old male with AAE and rapid aortic root expansion, who underwent ASO as a neonate and aortic valve replacement (AVR) as an adult. He was diagnosed as having dextro-(D-loop) transposition of the great arteries after birth and underwent ASO at the age of 13 months. At the age of 19 years, AVR was performed for progressive AR. AAE developed after AVR. In patients who have undergone neonatal ASO, AAE may occur following AVR decades later.

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Section: Introductionmentioning

confidence: 75%

Root aneurysm following aortic valve replacement 20 years after an arterial switch operation

et al. 2017

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“…When discussing the role of multimodality imaging in patients with Fontan circulation, it is necessary to mention that such imaging is fundamental in all the stages before TCPC, guiding clinicians to select good candidates for the Fontan pathway and identifying the right timing for the different steps [ 64 , 65 ]. Indeed, although the Fontan operation has significantly improved the survival in patients with single-ventricle physiologies [ 66 ], long-term morbidity and mortality are still important concerns, and several cardiac and extracardiac complications can occur [ 67 , 68 ]. Thus, the selection of candidates is the first step to increase the chances of survival after Fontan completion.…”

Section: Discussionmentioning

confidence: 99%

Role of Cardiovascular Imaging in the Follow-Up of Patients with Fontan Circulation

et al. 2022

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Since its first description in 1971, the Fontan procedure and its modifications have led to a substantial improvement in the survival rates of patients with a variety of types of complex Congenital Heart Disease (CHD) characterised by the presence of a single, dominant ventricle. However, despite the significant improvement of the prognosis over the years, Fontan patients are still exposed to several cardiovascular and systemic complications. It is, therefore, important to fully understand the pitfalls hidden behind a Fontan anatomy and the potential predictors of ventricular failure. Cardiovascular imaging plays a key role in this context, allowing for the early identification of complications with important prognostic implications. Echocardiography remains the first-line imaging modality for serial evaluation of Fontan patients. However, there is a growing role of cardiovascular magnetic resonance and cardiac computed tomography from pre-operative assessment to longitudinal follow-up. The aim of this paper will be to provide a comprehensive overview of the role, strengths, and weaknesses of each imaging modality in the assessment of congenital cardiac conditions palliated with the Fontan procedure.

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“…Although the Fontan procedure has been performed for longer than 40 years, research on epidemiology and outcomes of patients who have undergone this operation is limited to series from single [6][7][8] or multiple 9,10 centres. The data of the present study show the current nationwide status of post-Fontan patients in Japan.…”

Section: Discussionmentioning

confidence: 99%

Epidemiologic study of patients after Fontan operation based on Medical Aid Program for Chronic Pediatric Diseases of Specified Categories cohort

Fujii

Moriichi²,

Kakee³

et al. 2022

Cardiol Young

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Nationwide registry data of patients with single-ventricle physiology have been rarely reported. The Medical Aid Program for Chronic Pediatric Diseases of Specified Categories (Japan) has contributed to the financial support of medical expense for patients younger than 20 years with chronic paediatric disease, and almost all children in Japan who require disease-specific treatment voluntarily apply to this programme. The epidemiology and medium- to long-term outcome of patients following a Fontan procedure were investigated using the database. The usefulness of this epidemiologic investigation in identifying real-world objectives and clinical applications was also examined. A total of 2862 patients who underwent a Fontan operation were identified from 18,589 patients with chronic heart disease registered to the medical aid programme. The details of symptoms, treatment, and somatic growth were evaluated, from which we were able to clarify the nationwide data regarding the current status of post-Fontan patients younger than 20 years. This study elucidated the current status of post-Fontan patients under 20 years of age in Japan. Data analysis of the Medical Aid Program for Chronic Pediatric Diseases of Specified Categories cohort provided useful information towards understanding the comprehensive status of patients with chronic heart disease and contributed to improved disease management.

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Long-term follow-up of Fontan completion in adults and adolescents

Abstract: In patients who were ≥15 years old, the surgical results of the Fontan operation were acceptable. Approximately half of the late deaths were sudden deaths, mainly occurring 10-20 years postoperatively.

Cited by 8 publications

References 25 publications

Root aneurysm following aortic valve replacement 20 years after an arterial switch operation

Root aneurysm following aortic valve replacement 20 years after an arterial switch operation

Role of Cardiovascular Imaging in the Follow-Up of Patients with Fontan Circulation

Epidemiologic study of patients after Fontan operation based on Medical Aid Program for Chronic Pediatric Diseases of Specified Categories cohort

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