{"title":"Ventricular Morphology and Outcomes in Fontan Circulation without Hypoplastic Left Heart Syndrome: A Single-Center's Experience.","authors":"Han Wang, Jianrui Ma, Linjiang Han, Tong Tan, Wen Xie, Miao Tian, Zichao Tujia, Ying Li, Xiang Liu, Xiaobing Liu, Haiyun Yuan, Jimei Chen","doi":"10.31083/j.rcm2506193","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The impact of dominant ventricular morphology on Fontan patient outcomes remain controversial. This study evaluates long-term results of right ventricle (RV) dominance versus left ventricle (LV) dominance in Fontan circulation without hypoplastic left heart syndrome (HLHS).</p><p><strong>Methods: </strong>We retrospectively examined 323 Fontan operations from our center. To minimize pre- and intra-Fontan heterogeneity, 42 dominant RV patients were matched with 42 dominant LV patients using propensity score matching, allowing for a comparative analysis of outcomes between groups.</p><p><strong>Results: </strong>The mean follow-up was 8.0 <math><mo>±</mo></math> 4.6 years for matched RV dominant and 6.5 <math><mo>±</mo></math> 4.7 years for matched LV dominant group (<i>p</i> <math><mo>></mo></math> 0.05), showing no significant difference. The cumulative incidence of moderate or greater atrioventricular valve regurgitation was also comparable between the two groups (<i>p</i> <math><mo>></mo></math> 0.05). Similarly, 10-year freedom from death or transplantation following the Fontan operation was 84% <math><mo>±</mo></math> 7% in the matched dominant RV group, similar to 81% <math><mo>±</mo></math> 7% in the matched dominant LV group (<i>p</i> <math><mo>></mo></math> 0.05). The 10-year freedom from Fontan failure was 78% <math><mo>±</mo></math> 8% in the matched dominant RV group, also similar to 75% <math><mo>±</mo></math> 8% in the matched dominant LV group (<i>p</i> <math><mo>></mo></math> 0.05). Multivariate analysis did not identify RV dominance as a risk factor for Fontan failure (<i>p</i> <math><mo>></mo></math> 0.05).</p><p><strong>Conclusions: </strong>In the pre- and intra-Fontan context, RV dominance demonstrated similar and comparable long-term outcomes compared to LV dominance in non-HLHS Fontan circulation.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270118/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reviews in cardiovascular medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.31083/j.rcm2506193","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The impact of dominant ventricular morphology on Fontan patient outcomes remain controversial. This study evaluates long-term results of right ventricle (RV) dominance versus left ventricle (LV) dominance in Fontan circulation without hypoplastic left heart syndrome (HLHS).
Methods: We retrospectively examined 323 Fontan operations from our center. To minimize pre- and intra-Fontan heterogeneity, 42 dominant RV patients were matched with 42 dominant LV patients using propensity score matching, allowing for a comparative analysis of outcomes between groups.
Results: The mean follow-up was 8.0 4.6 years for matched RV dominant and 6.5 4.7 years for matched LV dominant group (p 0.05), showing no significant difference. The cumulative incidence of moderate or greater atrioventricular valve regurgitation was also comparable between the two groups (p 0.05). Similarly, 10-year freedom from death or transplantation following the Fontan operation was 84% 7% in the matched dominant RV group, similar to 81% 7% in the matched dominant LV group (p 0.05). The 10-year freedom from Fontan failure was 78% 8% in the matched dominant RV group, also similar to 75% 8% in the matched dominant LV group (p 0.05). Multivariate analysis did not identify RV dominance as a risk factor for Fontan failure (p 0.05).
Conclusions: In the pre- and intra-Fontan context, RV dominance demonstrated similar and comparable long-term outcomes compared to LV dominance in non-HLHS Fontan circulation.
期刊介绍:
RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.