Influence of ventricular morphology on outcome after the Fontan procedure

The modified Fontan procedure has gained wide acceptance in the treatment o f various congenital heart defects, Determination of risk factors for morta lity remains an important issue for optimizing patient selection for the Fo ntan procedure. Conflicting results have been reported about whether ventri cular morphology is a risk factor in these patients. Survival free of Fonta n takedown or cardiac transplantation was assessed in the first 500 patient s undergoing the Fontan procedure at our institution. This survival was cor related with ventricular morphology as evaluated by angiography, Both multi variate and univariate analyses indicated ventricular morphology was predic tive of early survival free of Fontan takedown or cardiac transplantation f ollowing the procedure. However, there wets no statistical evidence for ven tricular morphology being a risk factor for mortality in patients alive 6 m onths after the procedure. Ventricular morphology is a risk factor for earl y survival in patients undergoing a Fontan procedure, with left ventricular morphology associated with a better early survival than right ventricular morphology. (C) 2000 by Excerpta Medica, Inc.