Trial reportThe Journal of thoracic and cardiovascular surgery2016
Factors affecting Fontan length of stay: Results from the Single Ventricle Reconstruction trial.
Trial report in The Journal of thoracic and cardiovascular surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Tricuspid Valve Repair Can Restore the Prognosis of Patients with Hypoplastic Left Heart Syndrome and Tricuspid Valve Regurgitation: A Meta-analysis.Pediatric cardiology · 2024Pooled it
- Variation in care for children undergoing the Fontan operation for hypoplastic left heart syndrome.Cardiology in the young · 2019Trial
- Why stop at extubation?-the difference between enhanced recovery and on table extubation after paediatric cardiac surgery.Translational pediatrics · 2026Review
- Fontan Surgery in a Middle-Income Country: Outcomes and Modifiable Factors Potentially Associated with Risk - A 13-Year Single-Center Experience.Brazilian journal of cardiovascular surgery · 2026Observational
- Trends in Gaps of Care for Patients With Congenital Heart Disease: Implications for Social Determinants of Health and Child Opportunity Index.Journal of the American Heart Association · 2024Article
- Preoperative Hemodynamics Impact the Benefit of Fenestration on Fontan Postoperative Length of Stay.JACC. Advances · 2024Article
- Social Determinants of Health Including Child Opportunity Index Leading to Gaps in Care for Patients With Significant Congenital Heart Disease.Journal of the American Heart Association · 2024Article
- Predictive factors contributing to prolonged recovery in patients after Fontan operation.BMC pediatrics · 2022Article
- Center Variation in Chest Tube Duration and Length of Stay After Congenital Heart Surgery.The Annals of thoracic surgery · 2020Article
- Deep Learning for Improved Risk Prediction in Surgical Outcomes.Scientific reports · 2020Article
- Impact of Characteristics at Stage-2-Palliation on Outcome Following Fontan Completion.Pediatric cardiology · 2019Article
- Predicting Post-Fontan Length of Stay: The Limits of Measured Variables.Pediatric cardiology · 2019Article
- Neighborhood Socioeconomic Status and Outcomes Following the Norwood Procedure: An Analysis of the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Data Set.Journal of the American Heart Association · 2018Article
- Speckle-Tracking Echocardiography Improves Pre-operative Risk Stratification Before the Total Cavopulmonary Connection.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2017Article
- Melody valve-in-valve implantation in the tricuspid position through a Fontan conduit fenestration.Annals of pediatric cardiologyArticle
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Authors and funding
21 authors at 16 institutions in 2 countries.
Funding
Abstract
backgroundIn the Single Ventricle Reconstruction trial, infants with hypoplastic left heart syndrome (HLHS) who received a right-ventricle-to-pulmonary-artery shunt (RVPAS) versus a modified Blalock-Taussig shunt (MBTS) had lower early postoperative mortality, but more complications at 14 months. We explored the effect of shunt type and other patient, medical, and surgical factors on postoperative length of stay (LOS) after the Fontan operation.
methodsFontan postoperative course was ascertained from medical record review. Cox proportional hazards modeling was used to identify factors associated with LOS.
resultsOf 327 subjects who underwent Fontan, 323 were analyzed (1 death, 1 biventricular repair, 2 with missing data). Median age and weight at Fontan were 2.8 years (interquartile range [IQR]: 2.3, 3.4) and 12.7 kg (IQR: 11.4, 14.1), respectively. Fontan type was extracardiac in 55% and lateral tunnel in 45%; 87% were fenestrated. The RVPAS and MBTS subjects had similar LOS (median 11 days [IQR: 9, 18] vs 10 days [IQR: 9, 13]; P = .23). Independent risk factors for longer LOS were treatment center (P < .01), LOS at stage II (hazard ratio [HR] 1.02 for each additional day; P < .01), and pre-Fontan complications (HR 1.03 for each additional complication; P = .04). Use of deep hypothermic circulatory arrest at Fontan (HR 0.64; P = .02) was independently associated with shorter LOS. When center was excluded from the model, pre-Fontan complications and use of circulatory arrest were no longer significant; instead, older age at stage II (HR 1.08 for each additional month; P = .01) predicted longer LOS. In 254 subjects who had a pre-Fontan echocardiogram, at least moderate tricuspid regurgitation was independently associated with longer LOS, both with center (HR 1.72; P < .01) and without center in the model (HR 1.49; P = .02).
conclusionsIn this multicenter prospective cohort of subjects with HLHS, Norwood shunt type was not associated with Fontan LOS. Rather, global measures of earlier medical complexity indicate greater likelihood of longer LOS after the Fontan operation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.