Tacy Downing, MD, a fellow in the Cardiac Center at CHOP, presents her abstract on 20-Year Survival Rates in Single Ventricle Patients with Intact Fontan Circulation at Cardiology 2016 in Orlando, FL.
This single-center study analyzed 20 years of experience and long-term outcomes in children who underwent the Fontan operation for single-ventricle defects at The Children’s Hospital of Philadelphia between 1992 and 2009.
The researchers investigated 773 patients meeting inclusion criteria, 49 percent of whom had hypoplastic left heart syndrome. Median follow-up was 8.9 years, with one-third of the cohort having follow-up greater than 15 years. The study team measured a composite outcome of death, transplant or Fontan takedown. Risk factors for early death or loss of Fontan were having:
- A pre-1996 Fontan
- Post-operative pleural drainage greater than 14 days
- Prolonged ICU stay
- Longer aortic cross-clamp time
Risk factors for the late composite outcome were mild or greater AV valve regurgitation before Fontan and prolonged ICU stay.
The overall survival with intact Fontan circulation was 74 percent. For patients surviving to one year, the conditional survival estimate was 79 percent at 20 years.
Downing TE, et al. The Children’s Hospital of Philadelphia; Long-Term Survival with Intact Fontan Circulation in Single Ventricle Patients: Twenty Years of Experience at a Single Center