Evidence map›Paper›PMID 41082342›Full record

ArticleCirculation. Heart failure2025

Long-Term Outcomes After Fontan Conversion Operation: A Comparative Analysis Based on Type of Fontan Connection.

Amr Moustafa, Zeyad Kholeif, William R Miranda, Heidi M Connolly, Elizabeth H Stephens, Joseph A Dearani, Alexander C Egbe

Abstract readComparative Study
In one paragraph

Article in Circulation. Heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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  3. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Amr MoustafaDepartment of Cardiovascular Medicine (A.M., Z.K., W.R.M., H.M.C., A.C.E.), Mayo Clinic, Rochester, MN.ORCID 0009-0002-5133-3035
Zeyad KholeifDepartment of Cardiovascular Medicine (A.M., Z.K., W.R.M., H.M.C., A.C.E.), Mayo Clinic, Rochester, MN.
William R MirandaDepartment of Cardiovascular Medicine (A.M., Z.K., W.R.M., H.M.C., A.C.E.), Mayo Clinic, Rochester, MN.ORCID 0000-0001-8864-8474
Heidi M ConnollyDepartment of Cardiovascular Medicine (A.M., Z.K., W.R.M., H.M.C., A.C.E.), Mayo Clinic, Rochester, MN.ORCID 0000-0003-0666-0344
Elizabeth H StephensDepartment of Cardiovascular Surgery (E.H.S., J.A.D.), Mayo Clinic, Rochester, MN.ORCID 0000-0001-8709-6794
Joseph A DearaniDepartment of Cardiovascular Surgery (E.H.S., J.A.D.), Mayo Clinic, Rochester, MN.ORCID 0000-0002-2664-1290
Alexander C EgbeDepartment of Cardiovascular Medicine (A.M., Z.K., W.R.M., H.M.C., A.C.E.), Mayo Clinic, Rochester, MN.ORCID 0000-0002-8810-3631

Funding

Mechanisms of Clinical and Hemodynamic Response to Pulmonary Vasodilator Therapy in Fontan physiologyR01HL160761 · NHLBI · MAYO CLINIC ROCHESTER · PI Alexander Egbe · 2022 to 2026
$3.1M
Pathophysiologic Mechanism for Arrhythmias and Impaired Aerobic Capacity in Tetralogy of FallotR01HL158517 · NHLBI · MAYO CLINIC ROCHESTER · PI EGBE, ALEXANDER · 2021 to 2025
$2.9M
Clinical benefits and mechanism of action of angiotensin-II receptor blocker on Cardiovascular remodeling in patients with repaired coarctation of aortaR01HL162830 · NHLBI · MAYO CLINIC ROCHESTER · PI Alexander Egbe · 2023 to 2026
$2.7M
NHLBI NIH HHS R01 HL158517NHLBI NIH HHS R01 HL160761NHLBI NIH HHS R01 HL162830
6 · The paper itself

Abstract

backgroundFontan conversion (FC) is associated with a lower risk of atrial arrhythmias and thromboembolism, but it is unknown whether FC improves long-term survival. The purpose of this study was to assess the impact of FC on transplant-free survival.

methodAdults with Fontan palliation were divided into 3 groups: (1) atriopulmonary Fontan connection; (2) atriopulmonary Fontan and subsequent FC to total cavopulmonary connection (TCPC); (3) TCPC at initial Fontan operation. The risk of death/transplant was compared between the 3 groups using Cox regression analysis.

resultsWe studied 534 patients (age 27±9 years; males [N=298; 56%]). Patients were divided into atriopulmonary Fontan group (N=199, 37%); FC-TCPC (N=138, 26%); and TCPC (N=197, 37%). The FC-TCPC and TCPC groups have similar 15-year incidence of death/transplant (42% versus 47%;

conclusionsThese findings, in addition to the high operative mortality associated with FC, suggest that this may not be the optimal treatment option for most adults with atriopulmonary Fontan presenting with Fontan failure. Duration of Fontan physiology rather than the type of Fontan connection may be the main determinant of outcomes.

Indexed as

Fontan ProcedureHeart Defects, CongenitalAdolescentAdultFemaleHeart TransplantationHumansMaleRetrospective StudiesRisk FactorsTime FactorsTreatment OutcomeYoung Adultheart failureincidenceprevalencerisk factorsthromboembolism

Identifiers

PMID41082342
PMCPMC12597234

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