{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T18:31:11Z","timestamp":1782757871432,"version":"3.54.5"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>This study aimed to determine the longitudinal change of systemic ventricular function and atrioventricular valve (AVV) regurgitation after total cavopulmonary connection (TCPC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>In 620 patients who underwent TCPC between 1994 and 2021, 4219 longitudinal echocardiographic examinations of systemic ventricular function and AVV regurgitation were evaluated retrospectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The most frequent primary diagnosis was hypoplastic left heart syndrome in 172, followed by single ventricle in 131, tricuspid atresia in 95 and double inlet left ventricle (LV) in 91 patients. Dominant right ventricle (RV) was observed in 329 (53%) and dominant LV in 291 (47%). The median age at TCPC was 2.3 (1.8\u20133.4) years. Transplant-free survival at 5, 10 and 15\u2009years after TCPC was 96.3%, 94.7% and 93.6%, respectively, in patients with dominant RV and 97.3%, 94.6% and 94.6%, respectively, in those with dominant LV (P\u2009=\u20090.987). Longitudinal analysis of systemic ventricular function was similar in both groups during the first 10\u2009years postoperatively. Thereafter, systemic ventricular function worsened significantly in patients with dominant RV, compared with those with dominant LV (15\u2009years: P\u2009=\u20090.007, 20\u2009years: P\u2009=\u20090.03). AVV regurgitation was more frequent after TCPC in patients with dominant RV compared with those with dominant LV (P\u2009&amp;lt;\u20090.001 at 3\u2009months, 3\u2009years, 5\u2009years, 10\u2009years and 15\u2009years, P\u2009=\u20090.023 at 20\u2009years). There was a significant correlation between postoperative systemic ventricular dysfunction and AVV regurgitation (P\u2009&amp;lt;\u20090.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>There were no transplant-free survival difference and no difference in ventricular function between dominant RV and dominant LV for the first 10\u2009years after TCPC. Thereafter, ventricular function in dominant RV was inferior to that in dominant LV. The degree of AVV regurgitation was significantly higher in dominant RV, compared with dominant LV, and it was positively associated with ventricular dysfunction, especially in dominant RV.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad078","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T20:27:57Z","timestamp":1677702477000},"source":"Crossref","is-referenced-by-count":11,"title":["Longitudinal analysis of systemic ventricular function and atrioventricular valve function after the Fontan procedure"],"prefix":"10.1093","volume":"63","author":[{"given":"Vincent","family":"Dahmen","sequence":"first","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen , Munich, Germany"},{"name":"Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universit\u00e4t , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul Philipp","family":"Heinisch","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen , Munich, Germany"},{"name":"Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universit\u00e4t , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4034-3967","authenticated-orcid":false,"given":"Helena","family":"Staehler","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen , Munich, Germany"},{"name":"Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universit\u00e4t , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thibault","family":"Schaeffer","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen , Munich, Germany"},{"name":"Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universit\u00e4t , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8540-7090","authenticated-orcid":false,"given":"Melchior","family":"Burri","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"R\u00f6hlig","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich at the Technical University of Munich , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Klawonn","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Helmholtz Center for Infection Research , Braunschweig, Germany"},{"name":"Department of Computer Science, Ostfalia University , Wolfenb\u00fcttel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2481-2017","authenticated-orcid":false,"given":"Alfred","family":"Hager","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich at the Technical University of Munich , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0253-1190","authenticated-orcid":false,"given":"Peter","family":"Ewert","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich at the Technical University of Munich , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"H\u00f6rer","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen , Munich, Germany"},{"name":"Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universit\u00e4t , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5699-6394","authenticated-orcid":false,"given":"Masamichi","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen , Munich, Germany"},{"name":"Division of Congenital and Pediatric Heart Surgery, 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