The Fontan procedure is performed for a variety of congenital heart diseases when a circulation with 2 ventricles cannot be achieved. This results in a number of physiologic changes. In some patients a number of factors may contribute to worse long-term survival.
Factors associated with a worse long-term survival:
(1) male sex
(2) common atrioventricular valve (AVV), especially if there is moderate to severe regurgitation
(3) older age at Fontan operation
(4) elevated pulmonary artery pressure before surgery and in the early postoperative period
(5) concomitant surgery at the time of the Fontan operation
(6) prolonged pleural effusion after the Fontan procedure
(7) development of complications (arrhythmia, heart failure, liver disease, etc).
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