{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T06:17:51Z","timestamp":1793513871301,"version":"4.5.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"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":[[2026,2,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The Fontan operation and its modifications have transformed the management of children with functional single ventricle physiology. While outcomes have improved, peri-operative complications remain common. This study aimed to assess early outcomes and complications following Fontan completion in a large international European cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The EuroFontan registry is a multicentre retrospective study involving 21 congenital heart disease and transplant centres across Europe. Data were collected on patients who underwent Fontan surgery from January 1990 to January 2023. Analyses focused on the most recent 15-year period. A composite early adverse outcome (death within 30 days or in-hospital, low cardiac output syndrome, stroke, or Fontan takedown) was used. Predictors were assessed using multivariable mixed-effects logistic regression, with centre included as a random effect. Missing data were handled using multiple imputation with Rubin\u2019s rules, and sensitivity analyses were performed to assess robustness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 3510 patients, this analysis focused on 2075 individuals from the past 15 years, with a median age of 4.2 [interquartile range 3.2\u20136.2] years at Fontan completion. Early mortality was 1.0% (95% confidence interval .66%\u20131.54%). The composite adverse outcome occurred in 5.1% (95% confidence interval 4.2%\u20136.1%). On multivariable analysis, morphology other than tricuspid atresia was the only significant predictor of the composite outcome (odds ratio 2.2, 95% confidence interval 1.21\u20133.99, P = .01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Fontan surgery has evolved and, in contemporary practice, has low peri-operative morbidity and mortality. Morphology other than tricuspid atresia was associated with increased risk of early adverse outcomes, highlighting the importance of pre-operative risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehaf835","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T12:12:59Z","timestamp":1759320779000},"page":"842-850","source":"Crossref","is-referenced-by-count":10,"title":["Early outcomes of children with univentricular circulation undergoing Fontan surgery: the EuroFontan registry"],"prefix":"10.1093","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7535-9670","authenticated-orcid":false,"given":"Massimo A","family":"Padalino","sequence":"first","affiliation":[{"name":"Pediatric and Congenital Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova , Via Giustiniani 2, 35128 Padova ,","place":["Italy"]},{"name":"Department of Precision and Regenerative Medicine and Jonic Area, University of Bari \u2018Aldo Moro\u2019 , Piazza Giulio Cesare, 11, 70124 Bari ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Constantine","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton & Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , London ,","place":["UK"]},{"name":"National Heart and Lung Institute, Imperial College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Bergonzoni","sequence":"additional","affiliation":[{"name":"Pediatric and Congenital Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova , Via Giustiniani 2, 35128 Padova 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and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universit\u00e4t , Munich ,","place":["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, Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universit\u00e4t , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Sames-Dolzer","sequence":"additional","affiliation":[{"name":"Division of Pediatric and Congenital Heart Surgery, Kepler University Hospital , Linz 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