Skip to main content Accessibility help
×
Home
Hostname: page-component-747cfc64b6-nq4kt Total loading time: 0.544 Render date: 2021-06-17T09:38:24.781Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true }

Developing an adolescent and adult Fontan Management Programme

Published online by Cambridge University Press:  10 May 2021

Adam M. Lubert
Affiliation:
Cincinnati Children’s Hospital Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA Cincinnati Adult Congenital Heart Disease Program, Cincinnati Children’s Hospital Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Tarek Alsaied
Affiliation:
Cincinnati Children’s Hospital Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Andrew T. Trout
Affiliation:
Cincinnati Children’s Hospital Medical Center, Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Jonathan R. Dillman
Affiliation:
Cincinnati Children’s Hospital Medical Center, Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Joseph J. Palermo
Affiliation:
Cincinnati Children’s Hospital Medical Center, Division of Gastroenterology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Felicia Eichelbrenner
Affiliation:
Cincinnati Children’s Hospital Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Kelly Kleier
Affiliation:
Cincinnati Children’s Hospital Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Angela Lorts
Affiliation:
Cincinnati Children’s Hospital Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Nadeem Anwar
Affiliation:
Digestive Disease Division, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Marc G. Schecter
Affiliation:
Cincinnati Children’s Hospital Medical Center, Division of Pulmonology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Gregory M. Tiao
Affiliation:
Division of Transplant Surgery, Department of Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Clifford Chin
Affiliation:
Cincinnati Children’s Hospital Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
David S. Feldman
Affiliation:
Cincinnati Children’s Hospital Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA Division of Cardiovascular Medicine, Department of Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA
Meredith Jenkins
Affiliation:
Division of Pharmacy, Heart Institute, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
David LS Morales
Affiliation:
Cincinnati Children’s Hospital Heart Institute, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Alexander R. Opotowsky
Affiliation:
Cincinnati Children’s Hospital Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA Cincinnati Adult Congenital Heart Disease Program, Cincinnati Children’s Hospital Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
John C. Bucuvalas
Affiliation:
Recanati-Miller Transplant Institute and the Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Gruschen R. Veldtman
Affiliation:
Adult Congenital Heart Disease, Department of Pediatrics, Cincinnati Children’s Hospital and Heart Centre and King Faisal Specialist Hospital and Research Centre, Riyadh 45229, Saudi Arabia
Stuart L. Goldstein
Affiliation:
Cincinnati Children’s Hospital Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA Division of Nephrology and Hypertension, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Corresponding
E-mail address:

Abstract

Patients with single-ventricle CHD undergo a series of palliative surgeries that culminate in the Fontan procedure. While the Fontan procedure allows most patients to survive to adulthood, the Fontan circulation can eventually lead to multiple cardiac complications and multi-organ dysfunction. Care for adolescents and adults with a Fontan circulation has begun to transition from a primarily cardiac-focused model to care models, which are designed to monitor multiple organ systems, and using clues from this screening, identify patients who are at risk for adverse outcomes. The complexity of care required for these patients led our centre to develop a multidisciplinary Fontan Management Programme with the primary goals of earlier detection and treatment of complications through the development of a cohesive network of diverse medical subspecialists with Fontan expertise.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below.

References

Egbe, AC, Poterucha, JT, Warnes, CA et al. Hepatocellular Carcinoma After Fontan Operation. Circulation 2018; 138: 746748.CrossRefGoogle ScholarPubMed
Di Maria, MV, Barrett, C, Rafferty, C et al. Initiating a Fontan multidisciplinary clinic: decreasing care variability, improving surveillance, and subsequent treatment of Fontan survivors. Congenit Heart Dis 2019; 14: 590599.CrossRefGoogle ScholarPubMed
Downing, TE, Allen, KY, Glatz, AC et al. Long-term survival after the Fontan operation: twenty years of experience at a single center. J Thorac Cardiovasc Surg 2017; 154: 243253.e242.CrossRefGoogle ScholarPubMed
Gurvitz, M, Valente, AM, Broberg, C et al. Prevalence and predictors of gaps in care among adult congenital heart disease patients. J Am Coll Cardiol 2013; 61: 21802184.CrossRefGoogle ScholarPubMed
Dillman, JR, Trout, AT, Alsaied, T, Gupta, A, Lubert, AM Imaging of Fontan-associated liver disease. Pediatr Radiol 2020; 50: 15281541.CrossRefGoogle ScholarPubMed
Schumacher, KR, Kindel, SJ ACTION Committee: Considerations for Advanced Heart Failure Consultation in Fontan Patients.Google Scholar
Rychik, J, Atz, AM, Celermajer, DS et al. Evaluation and Management of the Child and Adult With Fontan Circulation: A Scientific Statement From the American Heart Association. Circulation 2019: Cir0000000000000696.CrossRefGoogle Scholar
Khairy, P, Fernandes, SM, Mayer, JE Jr. et al. Long-term survival, modes of death, and predictors of mortality in patients with Fontan surgery. Circulation 2008; 117: 8592.CrossRefGoogle ScholarPubMed
Alsaied, T, Allen, KY, Anderson, JB et al. The Fontan outcomes network: first steps towards building a lifespan registry for individuals with Fontan circulation in the United States. Cardiol Young 2020: 1–6.Google Scholar

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Developing an adolescent and adult Fontan Management Programme
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Developing an adolescent and adult Fontan Management Programme
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Developing an adolescent and adult Fontan Management Programme
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *