{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T08:17:41Z","timestamp":1771489061302,"version":"3.50.1"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Routine creation of a fenestration during Fontan completion is our policy to stabilize early circulation. This study evaluated its validity by examining the impact of fenestration patency at 1 year on long-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 112 patients who underwent fenestrated total cavopulmonary connection at 4 institutions, 105 with 1-year catheterization and \u22653 years of follow-up were analysed. Patients were classified by fenestration status at 1 year: patent (Group F, n\u2009=\u200943) and closed (Group C, n\u2009=\u200962). Preoperative and 1-year catheter data and long-term complications\u2014Fontan-associated liver disease (FALD), protein-losing enteropathy (PLE), and catheter interventions excluding veno-venous collaterals\u2014were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median age at Fontan was 23 months (interquartile range [IQR]: 15-33). Preoperative haemodynamics showed no differences between the groups. At postoperative 1 year, systemic ventricular end-diastolic pressure (SVEDP) was higher in Group F (F: 8 [5-9] vs C: 6 [5-8] mmHg, P\u2009=\u2009.007). Protein-losing enteropathy was significantly more common in the Group C (F: 5.0% vs C: 27.0%, P\u2009=\u2009.038). In contrast, there was no significant difference in the cumulative incidence of FALD between the 2 groups (F: 12.5% vs C: 9.7%, P\u2009=\u2009.69).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although patent fenestration was associated with an increased SVEDP at 1 year postoperatively, it may improve long-term outcomes including PLE. As predicting eventual fenestration patency from preoperative data is difficult, our policy of routine fenestration creation appears to be a valid strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical registration number<\/jats:title>\n                    <jats:p>Kitasato University, No. B23-130; February 7, 2024.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezag047","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T12:28:48Z","timestamp":1768912128000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of Fenestration Patency on Long-Term Fontan Outcomes"],"prefix":"10.1093","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8402-0867","authenticated-orcid":false,"given":"Sakura","family":"Horie","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, The University of Tokyo Hospital , Tokyo 113-8655,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9325-1877","authenticated-orcid":false,"given":"Fumiaki","family":"Shikata","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, The University of Tokyo Hospital , Tokyo 113-8655,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norihiko","family":"Oka","sequence":"additional","affiliation":[{"name":"Pediatric and Congenital Cardiovascular Surgery, Jichi Children\u2019s Medical Center , Tochigi, 329-0431,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Okamura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Gunma Children\u2019s Medical Center , Gunma, 377-0061,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryoichi","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kitasato University School of Medicine , Kanagawa, 252-0375,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Pediatric and Congenital Cardiovascular Surgery, Jichi Children\u2019s Medical Center , Tochigi, 329-0431,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuri","family":"Takei","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kitasato University School of Medicine , Kanagawa, 252-0375,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshikiyo","family":"Matsunaga","sequence":"additional","affiliation":[{"name":"Pediatric and Congenital Cardiovascular Surgery, Jichi Children\u2019s Medical Center , Tochigi, 329-0431,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenta","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kitasato University School of Medicine , Kanagawa, 252-0375,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsutomu","family":"Hataoka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Gunma Children\u2019s Medical Center , Gunma, 377-0061,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Konaka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kitasato University School of Medicine , Kanagawa, 252-0375,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minoru","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Cardiac 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