ReviewActa bio-medica : Atenei Parmensis2021
The pathophysiology and complications of Fontan circulation.
Review in Acta bio-medica : Atenei Parmensis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 2 of them syntheses that pooled it.
What it found
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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
51 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Biological tissue engineering for Fontan failure using decellularized extracellular matrix: a systematic review.Journal of translational medicine · 2026Pooled it
- Brazilian Guideline for Exercise Testing in Children and Adolescents - 2024.Arquivos brasileiros de cardiologia · 2024Guideline
- Phase 2 Open-label, Single-arm, Multi-center Clinical Trial to Evaluate the Efficacy and Safety of Camostat Mesylate in Patients with Protein-losing Enteropathy After Fontan Operation.Pediatric cardiology · 2026Trial
- Examination of elevated myocardial extracellular volume and exercise capacity in pediatric Fontan patients at moderate altitude.Pediatric radiology · 2026Article
- Serum Proteomic Profiling Implicates a Dysregulated Neurohormonal-Inflammatory Axis in Post-Fontan Sinus Tachycardia.Journal of the American Heart Association · 2026Article
- Varicocelectomy Restores Spermatogenesis in Fontan-Associated Varicocele: A Two-Case Series.IJU case reports · 2026Article
- Fontan-Related Lymphatic Complications: Incidence, Risk Factors, and Impact on Extracardiac Outcomes and Morbidity.Journal of the American Heart Association · 2026Article
- Successful medical management of recurrent atrial arrhythmia in a non-eligible Fontan patient to ablation: case report and literature review.Annals of medicine and surgery (2012) · 2026Article
- Aortic Dissection in a Patient With Fontan Physiology: Complex Emergency Repair and Tailored Coronary Reconstruction.JACC. Case reports · 2026Article
- A Dynamic 3D Human Liver Sinusoid Model for Mechanistic Interrogation of Fontan-Associated Liver Disease.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Prediction of Fontan failure and correlates of Fontan-associated liver disease severity using machine learning and radiomic features from multi-parametric abdominal MRI.Pediatric radiology · 2026Article
- Venous Measurements as Predictors of Long-Term Fontan Complications: A Single-Center Echocardiographic Study.Journal of clinical practice and research · 2026Article
- Do Hemodynamic and Echocardiographic Derangements After the Fontan Operation Correlate with Severity of Liver Disease on Biopsy?Pediatric cardiology · 2026Article
- Impact of Systemic Ventricular Morphology on Age-Adjusted (zlog-)NT-proBNP in Children with Univentricular Hearts.Pediatric cardiology · 2026Article
- Long-term survival and complications of Fontan patients: where do we stand?American journal of cardiovascular disease · 2026Review
- A One-Dimensional (1D) Computational Fluid Dynamics Study of Fontan-Associated Liver Disease (FALD).International journal for numerical methods in biomedical engineering · 2026Article
- The fate of the Fontan circulation.European heart journal supplements : journal of the European Society of Cardiology · 2026Article
- A second-hit conceptual framework for pulmonary arterial hypertension in adult congenital heart disease: genetics, hemodynamics, and treat-and-repair.Frontiers in cardiovascular medicine · 2026Review
- Pulmonary Vascular Endothelial Dysfunction Is Induced by Nonpulsatile Pulmonary Blood Flow in an Ovine Classic Glenn Model.Comprehensive Physiology · 2025Article
- Mountains and Waves: Fontan Circulation in Different Environmental Conditions.Pediatric cardiology · 2025Review
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The Fontan operation has been the final palliation for patients born with congenital heart defects with a functional single ventricle for more than 4 decades. The "normal" Fontan physiology is characterized by the loss of the sub-pulmonary ventricle with consequent elevated pressure in the caval system, non-pulsatile blood flow in the pulmonary circulation and at least mild reduction of the systemic output. When successful, this procedure is associated with a range of benefits including improved arterial saturation and abolishment of chronic volume overload, allowing a fairly normal life to the majority of patients through early adulthood. As we enter the 5th decade of caring for patients palliated with the Fontan procedure, it is evident that adult survivors face significant morbidity due to multiorgan dysfunction, early mortality and need for heart transplantation. Several late complications may occur: ventricular dysfunction, arrhythmia, cyanosis, exercise intolerance, elevated pulmonary vascular resistance, protein-losing enteropathy, plastic bronchitis, hepatic and renal complications. The mechanism of late Fontan failure is multifactorial and not completely understood, it depends on interactions between the ventricle, the pulmonary vascular bed, the venous and lymphatic compartments. Conclusions: the aim of this review is to describe the pathophysiology of Fontan circulation and the clinical and hemodynamic characteristics of early and late failing Fontan survivors, their association with morbidity and mortality, and the strategies for their management.
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Registered trials
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.