Table 1.
Clinical features in symptomatic adult versus pediatric Fontans
| Variable (Mean ± SD) | Adults, n = 27 (%) | Pediatric, n = 54 (%) | p |
|---|---|---|---|
| Age at catheterization (yrs) | 31.3 ± 9.3 | 13.7 ± 2.9 | <0.01 |
| Age at Fontan (yrs) | 10.6 ± 8 | 2.9 ± 2 | <0.01 |
| Time from Fontan to catheterization (yrs) | 20.7 ± 5.9 | 10.7 ± 3.8 | <0.01 |
| Male (%) | 52 | 46 | 0.71 |
| Height (cm) | 165.9 ± 33.5 | 150.8 ± 14.6 | 0.03 |
| Weight (kg) | 81.2 ± 18.8 | 45.7 ± 18.6 | <0.01 |
| Body surface area (m2) | 2 ± 0.3 | 1.4 ± 0.3 | <0.01 |
| NYHA functional class* | |||
| I and II | 48 | 94 | <0.01 |
| III and IV | 52 | 6 | |
| Atriopulmonary Fontan | 67 | 2 | <0.01 |
| Lateral tunnel Fontan | 33 | 69 | <0.01 |
| Extracardiac Fontan | 0 | 29 | <0.01 |
| Fontan fenestration | 11 | 87 | <0.01 |
| Systemic left ventricle | 81 | 44 | <0.01 |
| Systemic right ventricle | 19 | 56 | <0.01 |
| ACE inhibitor† | 41 | 74 | <0.01 |
| β Blocker† | 67 | 26 | <0.01 |
| Furosemide | 63 | 41 | 0.10 |
| Aldactone | 48 | 37 | 0.12 |
| Digoxin | 30 | 39 | 0.2 |
| Hemoglobin (g/dl) | 14.9 ± 2 | 14.6 ± 1.7 | 0.42 |
ACE = angiotensin-converting enzyme.
*
Among the adult Fontan cohort, 13 (48%) of the 27 patients were NYHA class I and II; however, only 2 of these were NYHA class I. Both patients had significant fluid overload despite diuretics.
†
ACE inhibitor and b-blocker use was not mutually exclusive. In the adult cohort, 8 patients (30%) were prescribed both medication classes, whereas 8 pediatric patients (15%) were prescribed both medicine types.