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Atrial arrhythmias and thromboembolic complications in adults post Fontan surgery
- Source :
- Open Heart, Vol 7, Iss 2 (2020), Open Heart
- Publication Year :
- 2020
- Publisher :
- BMJ, 2020.
-
Abstract
- ObjectivePatients with Fontan surgery experience late complications in adulthood. We studied the factors associated with the development and maintenance of atrial arrhythmias and thromboembolic complications in an adult population with univentricuar physiology post Fontan surgery.MethodsSingle centre retrospective cohort study of patients ≥18 years of age with Fontan circulation followed at our quaternary care centre for more than 1 year were included. Univariate and multivariate regression models were used where applicable to ascertain clinically significant associations between risk factors and complications.Results93 patients were included (age 30.2±8.8 years, 58% men). 28 (30%) had atriopulmonary Fontan connection, 35 (37.6%) had lateral tunnel Fontan and 29 (31.1%) had extracardiac Fontan pathway. After a mean of 7.27±5.1 years, atrial arrhythmia was noted in 37 patients (39.8%), of which 13 developed had atrial fibrillation (14%). The presence of atrial arrhythmia was associated with the number of prior cardiac surgeries/procedures, increasing age and prior atriopulmonary Fontan operation. Thromboembolic events were present in 31 patients (33%); among them 14 had stroke (45%), 3 had transient ischaemic attack (9.7%), 7 had pulmonary embolism (22.6%) and 5 had atrial thrombus with imaging (16.1%). The presence of thromboembolic events was only associated with age and the presence of cirrhosis in multivariate analysis.ConclusionsAtrial arrhythmias are common in adults with Fontan circulation at an early age, and are associated with prior surgical history and increasing age. Traditional risk factors may not be associated with atrial arrhythmia or thromboembolism in this cohort.
- Subjects :
- Adult
Heart Defects, Congenital
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty
Time Factors
Cirrhosis
Multivariate analysis
030204 cardiovascular system & hematology
Fontan Procedure
Risk Assessment
Young Adult
03 medical and health sciences
0302 clinical medicine
Risk Factors
Thromboembolism
Atrial Fibrillation
medicine
Humans
cardiovascular diseases
Stroke
Retrospective Studies
business.industry
Congenital Heart Disease
Age Factors
Atrial fibrillation
Retrospective cohort study
Atrial arrhythmias
medicine.disease
Pulmonary embolism
Surgery
Treatment Outcome
lcsh:RC666-701
Cohort
cardiovascular system
Female
Cardiology and Cardiovascular Medicine
business
arrhythmias
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 20533624
- Volume :
- 7
- Database :
- OpenAIRE
- Journal :
- Open Heart
- Accession number :
- edsair.doi.dedup.....895460354f37281fe3525fc50764a77a