{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T08:53:39Z","timestamp":1790758419754,"version":"4.1.0"},"reference-count":14,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2018,8,29]],"date-time":"2018-08-29T00:00:00Z","timestamp":1535500800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Although aspirin has been compared to warfarin for thromboembolic prophylaxis in the general Fontan population, little is known about the optimal preventative strategy for the atriopulmonary right atrium\u2013pulmonary artery [RA-PA]) Fontan particularly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cohort study was performed including adult patients identified in the Ahmanson\/UCLA Adult Congenital Heart Disease Center database with a history of RA-PA Fontan and use of either aspirin or warfarin as most recent primary prophylaxis against thromboembolism. Primary outcome was incident thromboembolism, defined as space-occupying lesion on imaging consistent with thrombus within the Fontan or pulmonary arterial circuit. Secondary outcomes were death, transplantation, Fontan conversion, and bleeding requiring either transfusion or invasive intervention. Follow-up was terminated upon achievement of a primary outcome or achievement of a secondary outcome other than bleeding. Kaplan-Meier analysis of freedom from thrombosis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty-six patients met inclusion criteria. Thirteen (50%) received aspirin as most recent primary prophylaxis and 13 (50%) received warfarin. Tricuspid atresia was the most common underlying diagnosis (42%), followed by double-inlet left ventricle (38%). Median age at Fontan operation was 8.2 years; median age at prophylaxis initiation was 25.9 years. After six years, the aspirin group had 50% \u00b1 35% freedom from thrombosis and the warfarin group 92% \u00b1 8% ( P = .15). Incidences of secondary outcomes were not significantly different between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this cohort of long-term Fontan survivors with RA-PA Fontan, the risk of thromboembolic complications is high, especially in those taking aspirin rather than warfarin. Larger studies are needed to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2150135118772837","type":"journal-article","created":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T00:05:59Z","timestamp":1535587559000},"page":"504-508","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Thromboprophylaxis in Adults With Atrio-Pulmonary Fontan"],"prefix":"10.1177","volume":"9","author":[{"given":"Adam J.","family":"Small","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Ahmanson\/UCLA Adult Congenital Heart Disease Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamil A.","family":"Aboulhosn","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Ahmanson\/UCLA Adult Congenital Heart Disease Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gentian","family":"Lluri","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Ahmanson\/UCLA Adult Congenital Heart Disease Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,8,29]]},"reference":[{"key":"bibr1-2150135118772837","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.738559"},{"key":"bibr2-2150135118772837","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)02472-9"},{"key":"bibr3-2150135118772837","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(00)70010-9"},{"key":"bibr4-2150135118772837","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.82.1.40"},{"key":"bibr5-2150135118772837","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2013.06.011"},{"key":"bibr6-2150135118772837","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.08.1023"},{"key":"bibr7-2150135118772837","doi-asserted-by":"publisher","DOI":"10.1136\/thx.26.3.240"},{"key":"bibr8-2150135118772837","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.065"},{"issue":"11","key":"bibr9-2150135118772837","first-page":"I157","volume":"116","author":"d\u2019Udekem Y","year":"2007","journal-title":"Circulation"},{"key":"bibr10-2150135118772837","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-307930"},{"key":"bibr11-2150135118772837","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.01.061"},{"key":"bibr12-2150135118772837","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-003-0684-z"},{"key":"bibr13-2150135118772837","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2004.05.051"},{"key":"bibr14-2150135118772837","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.06.056"}],"container-title":["World Journal for Pediatric and Congenital Heart Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2150135118772837","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2150135118772837","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2150135118772837","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:21:35Z","timestamp":1777591295000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2150135118772837"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,29]]},"references-count":14,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,9]]}},"alternative-id":["10.1177\/2150135118772837"],"URL":"https:\/\/doi.org\/10.1177\/2150135118772837","relation":{},"ISSN":["2150-1351","2150-136X"],"issn-type":[{"value":"2150-1351","type":"print"},{"value":"2150-136X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,29]]}}}