Table 3.

Long term Fontan surveillance

	Parameters	Monitoring
Constitutional	Adequate growth in childhood Weight or muscle loss in adulthood Avoid overweight Blood pressure: normotensive Functional classification, Aerobic activity Daily napping	Aerobic activity Exercise testing
Cardiac haemodynamics	Heart size Atrial dilatation Atriopulmonary anastomosis Pulmonary narrowing, distortion Pulmonary venous or atrioventricular (AV) inflow obstruction AV valve regurgitation or stenosis Aortic insufficiency Ventricular outflow obstruction Arch obstruction Ventricular function	Echocardiogram Periodic chest radiograph Cardiac MRI or CT
Rhythm	Presence of atrial versus junctional rhythm Resting heart rate Chronotropic response to exertion Arrhythmia development	Periodic 24 h ambulatory monitoring; event monitoring
Pulmonary	HypoxaemiaVascular resistance	Oxygen saturation, resting and exertional
Endocrine	Thyroid function	Thyroid stimulating hormone (TSH), thyroxine (T4)
Renal		Blood urea nitrogen, creatinine
Hepatic	Hepatomegaly Cardiac cirrhosis Synthetic function	Liver function: enzymes, coagulation Abdominal ultrasound, CT or MR Liver biopsy Serum α-fetoprotein
Gastrointestinal	Bloating, distension, diarrhoea, ascites, gallstones	Stool α-1 anti-trypsin
Haematologic	Anaemia, polycythaemia, thrombocytopenia	Blood count, platelets
Metabolic		B-type natriuretic peptide, albumin, alkaline phosphatase
Neurologic	Cerebrovascular accident Depression