{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T05:41:48Z","timestamp":1771047708118,"version":"3.50.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T00:00:00Z","timestamp":1554076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>Our unit has pursued Fontan completion in all patients except those with immobility or combined poor ventricular function and high pulmonary artery pressures. We assessed retrospectively whether conventional high-risk criteria would predict patients with a poorer outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>One hundred and thirty-three consecutive children who underwent extracardiac Fontan completion (2004\u20132012) had their outcomes recorded (mean follow-up of 7\u2009years). Three groups were analysed: those with 1 of 6 historical risk factors (outside 6 commandments), those with 1 of reduced systemic ventricular function or pulmonary artery pressure &gt;15\u2009mmHg (outside 2 commandments) versus those with no contraindications. The Fischer\u2019s exact test examined frequency differences, with the \u03c72 test to look for outcome associations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>There were no differences in postoperative complication rates between the outside 6 commandments (n\u2009=\u2009105) or outside 2 commandments (n\u2009=\u200949) versus the low-risk no-contraindication group (n\u2009=\u200928): arrhythmias [18% (P\u2009=\u20090.3) or 18% (P\u2009=\u20090.3) vs 25%], infection [22% (P\u2009=\u20090.6) or 33% (P\u2009=\u20090.2) vs 21%], cerebrovascular accident [6% (P\u2009=\u20090.5) or 10% (P\u2009=\u20090.3) vs 4%], length of stay [20\u2009days (P\u2009=\u20090.4) or 23\u2009days (P\u2009=\u20090.2) vs 21\u2009days] and duration of chest drainage (P\u2009=\u20090.5). There was 1 predischarge mortality in each group. Long term, the majority of patients in each group had suitable haemodynamics for fenestration closure [95% (P\u2009=\u20090.7) or 95% (P\u2009=\u20090.7) vs 92%]. Long term, there was no difference in the rate of arrhythmias [11% (P\u2009=\u20090.5) or 12.5% (P\u2009=\u20090.3) vs 7%], protein-losing enteropathy [1% (P\u2009=\u20090.1) or 2% (P\u2009=\u20090.3) vs 7%] or moderate or more ventricular dysfunction on echocardiography [2% (P\u2009=\u20090.7) or 4% (P\u2009=\u20090.7) vs 4%]. Notably, there was a higher rate of catheter reinterventions in the high-risk groups [22% (P\u2009&lt;\u20090.05) or 24% (P\u2009&lt;\u20090.05) vs 7%].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The medium-term benefits of Fontan completion can be achieved for high-risk patients, suggesting that historical selection criteria should be re-examined.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezz069","type":"journal-article","created":{"date-parts":[[2019,3,11]],"date-time":"2019-03-11T08:08:02Z","timestamp":1552291682000},"page":"664-670","source":"Crossref","is-referenced-by-count":5,"title":["High-risk Fontan completion patients achieve low perioperative risk and benefit from cavopulmonary connection 7 years out\u2020"],"prefix":"10.1093","volume":"56","author":[{"given":"Gaia","family":"Vigano","sequence":"first","affiliation":[{"name":"Department of Paediatric Cardiothoracic Surgery, Our Lady\u2019s Children\u2019s Hospital Crumlin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin J","family":"McMahon","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Our Lady\u2019s Children\u2019s Hospital Crumlin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Our Lady\u2019s Children\u2019s Hospital Crumlin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Oslizlok","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Our Lady\u2019s Children\u2019s Hospital Crumlin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orla","family":"Franklin","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Our Lady\u2019s Children\u2019s Hospital Crumlin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Nolke","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiothoracic Surgery, Our Lady\u2019s Children\u2019s Hospital Crumlin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M","family":"Redmond","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiothoracic Surgery, Our Lady\u2019s Children\u2019s Hospital Crumlin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Byrne","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University of Toronto, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan G","family":"McGuinness","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiothoracic Surgery, Our Lady\u2019s Children\u2019s Hospital Crumlin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,4,1]]},"reference":[{"key":"2019091904513793100_ezz069-B1","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.ahj.2013.04.013","article-title":"Age at Fontan procedure impacts exercise performance in adolescents: results from the Pediatric Heart Network Multicenter study","volume":"166","author":"Madan","year":"2013","journal-title":"Am Heart J"},{"key":"2019091904513793100_ezz069-B2","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4103\/apc.APC_43_17","article-title":"Exercise performance after univentricular palliation","volume":"11","author":"Talwar","year":"2018","journal-title":"Ann Pediatr Cardiol"},{"key":"2019091904513793100_ezz069-B3","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.ejcts.2006.11.043","article-title":"Factors influencing early and late outcome following the Fontan procedure in the current era. 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