Clinical Phenotypes of Fontan Failure: Implications for Management

Congenit Heart Dis. 2016 Jul;11(4):296-308. doi: 10.1111/chd.12368. Epub 2016 May 26.

Abstract

Fontan failure has been variably and inconsistently described in the literature, leading to challenges in comparing studies and evaluating treatments. Development of a conceptual framework to describe clinical phenotypes will aid in consistent terminology in the literature. In the heart failure literature, several key concepts have been described-"heart failure" is a clinical syndrome of various etiologies, with phenotype-specific response to therapies. As the congenital heart disease community struggles to grapple with "Fontan failure," these concepts come to light. Fontan failure in the context of four clinical phenotypes, including evaluation, potential management strategies, and future directions is discussed.

Keywords: Cirrhosis; Congenital Heart Disease; Fontan; Heart Failure; Hemodynamics; Portal Hypertension.

Publication types

  • Review

MeSH terms

  • Fontan Procedure / adverse effects*
  • Heart Defects, Congenital / diagnosis
  • Heart Defects, Congenital / physiopathology
  • Heart Defects, Congenital / surgery*
  • Hemodynamics
  • Humans
  • Lymphatic System / physiopathology
  • Phenotype
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / therapy*
  • Regional Blood Flow
  • Risk Factors
  • Stroke Volume
  • Treatment Failure
  • Ventricular Pressure