Hemodynamic determinants of mortality after Fontan operation

Background Elevated central venous pressure (CVP), low cardiac output, and mild hypoxia are common early and late after Fontan operations. However, the association of these characteristics with late mortality is unclear. We aimed to elucidate the hemodynamic determinants of mortality after Fontan operation. Method We evaluated early (group early; 0.5-5 years postoperatively, n = 387) and late (group late; ≥15 years postoperatively, n = 161) Fontan hemodynamics that included CVP (mm Hg), cardiac index (CI; L/min per m 2 ), systemic ventricular end-diastolic volume index (mL/m 2 ), ejection fraction (EF; %), and arterial blood oxygen saturation (%). We examined the effect of these variables on 5-year all-cause mortality. Results Mortality was higher in group late than in group early (17 vs 11, P P P P P P Conclusions Elevated CVP and low arterial blood oxygen saturation correlate with mortality in both early and late Fontan survivors. End-diastolic volume index and EF are associated with mortality only in the earlier cohort, whereas interestingly, elevated cardiac output is associated with increased mortality in the later cohort.