{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T20:53:12Z","timestamp":1793047992378,"version":"4.5.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,12,19]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Data on the use of implanted hemodynamic monitoring (IHM) in patients with Fontan circulation are limited. This study reports our experience using the CardioMEMS HF system in adults with Fontan circulation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This single\u2010center, retrospective study evaluated heart failure hospitalizations, procedural complications, and device\u2010related complications in patients with Fontan circulation referred for IHM placement (2015\u20132022). The association of pulmonary artery pressure (by most recent catheterization and median IHM pressure within 30\u2009days of placement) with both death and follow\u2010up Model for End\u2010Stage Liver Disease Excluding International Normalized Ratio score were evaluated. Of 18 patients referred for IHM placement, 17 were successful (median age, 30 [range 21\u201348] years, 6 women). Procedural complications (access site hematomas, pulmonary artery staining) occurred in 3 patients, without device\u2010related procedural complications. In follow\u2010up (median, 35 [range, 6\u201383] months), 1 patient developed a pulmonary embolism (possibly device\u2010related). Heart failure hospitalizations\/year were similar before and after IHM (median, 1 [interquartile range, 0\u20131.0] versus 0.6 [0\u20132.3];\n              <jats:italic>P<\/jats:italic>\n              =0.268), though only 46% of heart failure hospitalizations had associated IHM transmissions. IHM pressures were associated with Model for End\u2010Stage Liver Disease Excluding International Normalized Ratio scores (\n              <jats:italic>R<\/jats:italic>\n              <jats:sup>2<\/jats:sup>\n              =0.588,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), though catheterization pressures were not (\n              <jats:italic>R<\/jats:italic>\n              <jats:sup>2<\/jats:sup>\n              =0.140,\n              <jats:italic>P<\/jats:italic>\n              =0.139). The long\u2010term mortality rate was 53% in this cohort. On unadjusted survival analysis, IHM pressures \u226518\u2009mm\u2009Hg were associated with mortality (log rank\n              <jats:italic>P<\/jats:italic>\n              =0.041), which was not reproduced with catheterization pressures (log rank\n              <jats:italic>P<\/jats:italic>\n              =0.764).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In patients with Fontan circulation, IHM did not reduce heart failure hospitalizations, though patient adherence to transmission was low. Device\u2010related complications were low. IHM pressures may better represent real\u2010life conditions compared with catheterization given associations with mortality and Model for End\u2010Stage Liver Disease Excluding International Normalized Ratio score.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.031836","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T11:06:21Z","timestamp":1702033581000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Early Experience and Lessons Learned Using Implanted Hemodynamic Monitoring in Patients With Fontan Circulation"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7350-6991","authenticated-orcid":false,"suffix":"V","given":"William H.","family":"Marshall","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine The Ohio State University Wexner Medical Center Columbus 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K.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Nationwide Children\u2019s Hospital, The Heart Center Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9632-4725","authenticated-orcid":false,"given":"Arash","family":"Salavitabar","sequence":"additional","affiliation":[{"name":"Nationwide Children\u2019s Hospital, The Heart Center Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenne","family":"Hickey","sequence":"additional","affiliation":[{"name":"Nationwide Children\u2019s Hospital, The Heart Center Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Metzger","sequence":"additional","affiliation":[{"name":"Nationwide Children\u2019s Hospital, The Heart Center Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey","family":"Sisk","sequence":"additional","affiliation":[{"name":"Nationwide Children\u2019s Hospital, The Heart Center Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4201-6337","authenticated-orcid":false,"given":"Curt J.","family":"Daniels","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine The Ohio State University Wexner Medical Center Columbus OH"},{"name":"Nationwide Children\u2019s Hospital, The Heart Center Columbus 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