Contemporary outcomes of the Fontan operation: An Australian and New Zealand Fontan Registry study

Objective: We sought to review the impact of extracardiac conduit size and risk factors on the long-term outcomes of the contemporary Fontan procedure: lateral tunnel and extracardiac conduits. Methods: Data were collected from a binational registry. Composite outcome of late adverse events included death, transplant, Fontan failure, supraventricular tachycardia (SVT), thromboembolism, or pacemaker implantation. Results: = .025, respectively). Landmark analysis was performed from 16 years of age in patients without Fontan failure (n = 813). Transplant-free survival and freedom from Fontan failure were 87% (95% CI, 81%-91%) and 80% (95% CI, 72%-85%) at 20 years from this time point, respectively. Conclusions: Despite recent suggestions, extracardiac conduit sizes do not appear to affect long-term clinical outcomes. Patients with lateral tunnel have a greater incidence of sustained SVT, and Fontan fenestration may increase incidence of late adverse events.