Plasma volume status in patients after Fontan operation: Prognostic value and the associations with Fontan pathophysiology

Abstract Background Assessment of plasma volume status (PVS) is essential for the management of patients with heart failure (HF). We aimed to elucidate the clinical features of PVS in patients with Fontan circulation (FC). Methods Plasma volume (PV) was measured via pulse dye densitometry (icg-PV) and compared with the calculated PV (c-PV) in 114 patients with FC and 32 with biventricular circulation (BVC). We derived the PVS (%) [{(c-PV－ideal-PV)/ideal-PV} ​× ​100] and elucidated its clinical associations in 275 consecutive patients with FC and 493 with BVC. Results The c-PV correlated with the icg-PV in FC (r ​= ​0.70) and BVC (r ​= ​0.67) (p ​ Conclusions Compared with BVC, FC was associated with increased BV but contracted PV. Regarding Fontan, a higher PVS is associated with a phenotype of high output HF and higher risk of adverse outcomes.