{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:42:24Z","timestamp":1787168544621,"version":"build-2736575974"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T00:00:00Z","timestamp":1585872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Cristina Ramona Radulescu"},{"DOI":"10.13039\/501100000860","name":"European Society of Cardiology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000860","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000186","name":"ESC","doi-asserted-by":"publisher","award":["T-2018-21282"],"award-info":[{"award-number":["T-2018-21282"]}],"id":[{"id":"10.13039\/501100000186","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: \u2018In [patients undergoing Fontan palliation] does [fenestration] affect [early and late postoperative outcomes]?\u2019 Altogether 509 papers were found using the reported search, of which 11 papers represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Current data suggest that the use of fenestration has advantages in the immediate postoperative course, with fewer complications such as pleural effusions, shorter hospitalization and decreased early Fontan failure, but comparable long-term outcomes to a non-fenestrated approach. Fenestration should be used in high-risk patients or based on the haemodynamic parameters measured before weaning from cardiopulmonary bypass. Routine use may potentially lead to additional late fenestration closure procedures in some patients, without improving long-term outcomes.<\/jats:p>","DOI":"10.1093\/icvts\/ivaa002","type":"journal-article","created":{"date-parts":[[2020,1,8]],"date-time":"2020-01-08T07:09:49Z","timestamp":1578467389000},"page":"773-779","source":"Crossref","is-referenced-by-count":13,"title":["Does routine fenestration improve early and late postoperative outcomes in patients undergoing Fontan palliation?"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1267-4988","authenticated-orcid":false,"given":"Alexandra","family":"Toncu","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Bristol Royal Hospital for Children, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4625-9344","authenticated-orcid":false,"given":"Cristina Ramona","family":"R\u0103dulescu","sequence":"first","affiliation":[{"name":"Department of Adult Congenital Heart Disease, Bristol Heart Institute, Bristol, UK"},{"name":"Department of Pediatric Cardiology, Bristol Royal Hospital for Children, Bristol, UK"},{"name":"Department of Pediatrics, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2443-1019","authenticated-orcid":false,"given":"Dan","family":"Doroban\u0163u","sequence":"first","affiliation":[{"name":"University of Exeter, College of Life and Environmental Sciences, Exeter, UK"},{"name":"Department of Cardiology, Bristol Royal Hospital for Children, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0218erban","family":"Stoica","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Bristol Royal Hospital for Children, Bristol, UK"},{"name":"Department of Adult Congenital Heart Disease, Bristol Heart Institute, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,4,3]]},"reference":[{"key":"2020042503254758900_ivaa002-B1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/S1569-9293(03)00191-9","article-title":"Towards evidence-based medicine in cardiothoracic surgery: best BETS","volume":"2","author":"Dunning","year":"2003","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2020042503254758900_ivaa002-B2","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1007\/s00246-010-9811-9","article-title":"Fontan \u201cTen Commandments\u201d revisited and revised","volume":"31","author":"Stern","year":"2010","journal-title":"Pediatr Cardiol"},{"key":"2020042503254758900_ivaa002-B3","doi-asserted-by":"crossref","first-page":"e16554","DOI":"10.1097\/MD.0000000000016554","article-title":"Comparison of the fenestrated and non-fenestrated Fontan procedures: a meta-analysis","volume":"98","author":"Li","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"2020042503254758900_ivaa002-B4","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1161\/01.CIR.86.6.1762","article-title":"Effect of baffle fenestration on outcome of the modified Fontan operation","volume":"86","author":"Bridges","year":"1992","journal-title":"Circulation"},{"key":"2020042503254758900_ivaa002-B5","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.1016\/S0003-4975(00)01247-9","article-title":"Univentricular repair: is routine fenestration justified?","volume":"69","author":"Airan","year":"2000","journal-title":"Ann Thorac Surg"},{"key":"2020042503254758900_ivaa002-B6","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1161\/hc0202.102237","article-title":"Fenestration improves clinical outcome of the Fontan procedure: a prospective, randomized study","volume":"105","author":"Lemler","year":"2002","journal-title":"Circulation"},{"key":"2020042503254758900_ivaa002-B7","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.ejcts.2006.08.025","article-title":"Clinical outcome of patients 20 years after Fontan operation\u2014effect of fenestration on late morbidity","volume":"30","author":"Ono","year":"2006","journal-title":"Eur J Cardiothorac Surg"},{"key":"2020042503254758900_ivaa002-B8","first-page":"2335","article-title":"Fontan extracardiac tunnel connection: fenestration or not?","volume":"122","author":"Fu","year":"2009","journal-title":"Chin Med J"},{"key":"2020042503254758900_ivaa002-B9","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.jtcvs.2010.03.013","article-title":"Fenestration during Fontan palliation: now the exception instead of the rule","volume":"140","author":"Salazar","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2020042503254758900_ivaa002-B10","doi-asserted-by":"crossref","first-page":"2437","DOI":"10.1016\/j.jacc.2011.01.031","article-title":"Pediatric Heart Network Investigators. Late status of Fontan patients with persistent surgical fenestration","volume":"57","author":"Atz","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2020042503254758900_ivaa002-B11","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/j.athoracsur.2013.11.041","article-title":"Comparison of fenestrated and nonfenestrated patients undergoing extracardiac Fontan","volume":"97","author":"Fiore","year":"2014","journal-title":"Ann Thorac Surg"},{"key":"2020042503254758900_ivaa002-B12","doi-asserted-by":"crossref","first-page":"2532","DOI":"10.1016\/j.jtcvs.2014.06.062","article-title":"Persistent fenestration may be a marker for physiologic intolerance after Fontan completion","volume":"148","author":"Kotani","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2020042503254758900_ivaa002-B13","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1007\/s00246-016-1561-x","article-title":"Effect of fenestration on early postoperative outcome in extracardiac Fontan patients with different risk levels","volume":"38","author":"Fan","year":"2017","journal-title":"Pediatr Cardiol"},{"key":"2020042503254758900_ivaa002-B14","doi-asserted-by":"crossref","first-page":"3506","DOI":"10.12659\/MSM.905786","article-title":"Long-term effects of percutaneous fenestration following the Fontan procedure in adult patients with congenital univentricular heart","volume":"24","author":"Sma\u015b-Suska","year":"2018","journal-title":"Med Sci Monit"}],"container-title":["Interactive CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/icvts\/article-pdf\/30\/5\/773\/33126494\/ivaa002.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/icvts\/article-pdf\/30\/5\/773\/33126494\/ivaa002.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,25]],"date-time":"2020-04-25T03:26:01Z","timestamp":1587785161000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/30\/5\/773\/5815630"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,3]]},"references-count":14,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,4,3]]},"published-print":{"date-parts":[[2020,5,1]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivaa002","relation":{},"ISSN":["1569-9285"],"issn-type":[{"value":"1569-9285","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,5]]},"published":{"date-parts":[[2020,4,3]]}}}