Patients with Fontan circulatory failure face higher mortality risk while awaiting or after undergoing heart transplantation, if they have certain health complications, according to a multi-center study published in Circulation.
Researchers analyzed data from 409 patients across 20 U.S. medical centers who had undergone the Fontan procedure and were listed for transplant between 2008 and 2022. They found 5.9% died while waiting and 8.5% died within a year after transplant. Risk factors included repeated hospitalizations in the year before listing, clinical cyanosis — which increased mortality risk fivefold — sleep apnea, mental health conditions requiring treatment and anatomical complications, such as Fontan pathway obstruction.
The findings aim to help clinicians identify high-risk patients sooner and guide earlier referrals for advanced heart failure care and transplantation.
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