{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:51:45Z","timestamp":1791960705122,"version":"4.3.4"},"reference-count":118,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T00:00:00Z","timestamp":1722988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Over the past five decades, the Fontan procedure has been developed to improve the life expectancy of patients with congenital heart defects characterized by a functionally single ventricle. The Fontan circulation aims at redirecting systemic venous return to the pulmonary circulation in the absence of an impelling subpulmonary ventricle, which makes this physiology quite fragile and leads to several long-term complications. Despite the importance of hemodynamic assessment through cardiac catheterization in the management and follow-up of these patients, a thorough understanding of the ultimate functioning of this type of circulation is lacking, and the interpretation of the hemodynamic data is often complex. In recent years, new tools such as combined catheterization with cardiopulmonary exercise testing have been incorporated to improve the understanding of the hemodynamic profile of these patients. Furthermore, extensive percutaneous treatment options have been developed, addressing issues ranging from obstructive problems in Fontan pathway and acquired shunts through compensatory collaterals to the percutaneous treatment of lymphatic circulation disorders and transcatheter edge-to-edge repair of atrioventricular valves. The aim of this review is to detail the various tools used in cardiac catheterization for patients with Fontan circulation, analyze different percutaneous treatment strategies, and discuss the latest advancements in this field.<\/jats:p>","DOI":"10.3390\/jcm13164633","type":"journal-article","created":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T07:01:25Z","timestamp":1723100485000},"page":"4633","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Advances in Diagnostic and Interventional Catheterization in Adults with Fontan Circulation"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0723-1023","authenticated-orcid":false,"given":"Yassin","family":"Belahnech","sequence":"first","affiliation":[{"name":"Adult Congenital Heart Disease Unit, Cardiology Department, Vall d\u2019Hebron University Hospital, Vall d\u2019Hebron Research Institute, Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard","family":"Mart\u00ed Aguasca","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease Unit, Cardiology Department, Vall d\u2019Hebron University Hospital, Vall d\u2019Hebron Research Institute, Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5821-4501","authenticated-orcid":false,"given":"Laura","family":"Dos Subir\u00e0","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease Unit, Cardiology Department, Vall d\u2019Hebron University Hospital, Vall d\u2019Hebron Research Institute, Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart), Coordinating Center in Amsterdam, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1136\/thx.26.3.240","article-title":"Surgical repair of tricuspid atresia","volume":"26","author":"Fontan","year":"1971","journal-title":"Thorax"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"E234","DOI":"10.1161\/CIR.0000000000000696","article-title":"Evaluation and Management of the Child and Adult with Fontan Circulation: A Scientific Statement from the American Heart Association","volume":"140","author":"Rychik","year":"2019","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/j.jacc.2017.12.054","article-title":"Clinical Outcomes in Adolescents and Adults after the Fontan Procedure","volume":"71","author":"Dennis","year":"2018","journal-title":"J. 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