Considerations for Advanced Heart Failure Consultation in Individuals With Fontan Circulation: Recommendations From ACTION. (21st February 2023)

• Record Type: Journal Article
• Authors: Lubert, Adam M.; Cedars, Ari; Almond, Christopher S.; Amdani, Shahnawaz; Conway, Jennifer; Friedland-Little, Joshua M.; Gajarski, Robert J.; Kindel, Steven J.; Lorts, Angela; Morales, David L.S.; O'Connor, Matthew J.; Peng, David M.; Rosenthal, David N.; Smyth, Lauren; Sutcliffe, David L.; Schumacher, Kurt R.
• Is Part Of: Circulation. Volume 16:Number 2(2023)
• Page Start: e010123
• Publication Date: 2023-02-21
• Subjects: congenital heart disease -- Fontan procedure -- heart failure -- transplantation -- ventricular dysfunction; Heart failure -- Periodicals; 616.129005
• DOI: 10.1161/CIRCHEARTFAILURE.122.010123
• Languages: English
• ISSNs: 1941-3289

Abstract

Abstract : Individuals with Fontan circulation are at risk of late mortality from both cardiac and noncardiac causes. Despite the known risk of mortality, referral indications for advanced heart failure care vary between centers, and many individuals die from Fontan circulation-related complications either after late consideration for advanced heart failure therapies or having never seen a heart failure specialist. There is a critical need for guidelines to direct appropriately timed referral for advanced heart failure consultation. The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) Fontan Committee has developed recommended thresholds for advanced heart failure referral to guide primary cardiologists. These recommendations are divided into 4 categories of clinical Fontan circulatory dysfunction including (1) cardiac/systemic ventricular dysfunction, (2) Fontan pathway dysfunction, (3) lymphatic dysfunction, and (4) extracardiac dysfunction.