PMID- 27390988
OWN - NLM
STAT- MEDLINE
DCOM- 20170829
LR  - 20170829
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 220
DP  - 2016 Oct 1
TI  - When is the right time for Fontan conversion? The role of cardiopulmonary 
      exercise test.
PG  - 564-8
LID - S0167-5273(16)31217-7 [pii]
LID - 10.1016/j.ijcard.2016.06.209 [doi]
AB  - BACKGROUND: To determine if Fontan conversion (FC) resulted in improvement in 
      exercise capacity (EC), and to determine the role of cardiopulmonary exercise 
      test (CPET) in risk stratification of patients undergoing FC. METHODS: A 
      retrospective review of patients who underwent CPET prior to FC at Mayo Clinic 
      from 1994 to 2014. The patients who also underwent post-operative CPET were 
      selected for the analysis of improvement in EC defined as 10% increase in 
      baseline peak oxygen consumption (VO2). RESULTS: 75 patients CPET prior to FC; 
      mean age 24+/-6years; 44 males (59%); and 51 (68%) were in NYHA III/IV prior to FC. 
      Pre-operative peak VO2 was 15.5+/-3.4ml/kg/min. A comparison of pre- and post-FC 
      CPET data was performed using 42 patients (56%) that underwent CPET after FC. 
      Improvement in EC occurred in 18 of 42 patients (43%). Baseline peak VO2 
      >14ml/kg/min was associated with improved EC (hazard ratio [HR] 1.85; P=.02). 
      Improvement in New York Heart Association (NYHA) class occurred in 12 (67%) 
      patients with improved EC vs 2 (8%) without improved EC. Improvement in NYHA 
      class was more likely to occur in patients with improved EC compared to those 
      without improvement EC (odds ratio 4.11, P=.01). There were 10 (13%) 
      perioperative deaths, and baseline peak VO2 </=14ml/kg/min was predictive of 
      perioperative mortality (HR 3.74; P<.001). CONCLUSIONS: Baseline peak VO2 was 
      predictive of perioperative survival, and improvement in EC. Performance on CPET 
      in failing Fontan patients might be a useful clinical parameter in determining 
      appropriate timing of FC.
CI  - Copyright (c) 2016 Elsevier Ireland Ltd. All rights reserved.
FAU - Egbe, Alexander C
AU  - Egbe AC
AD  - Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. 
      Electronic address: egbe.alexander@mayo.edu.
FAU - Connolly, Heidi M
AU  - Connolly HM
AD  - Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. 
      Electronic address: connolly.heidi@mayo.edu.
FAU - Dearani, Joseph A
AU  - Dearani JA
AD  - Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA. Electronic 
      address: jdearani@mayo.edu.
FAU - Bonnichsen, Crystal R
AU  - Bonnichsen CR
AD  - Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
FAU - Niaz, Talha
AU  - Niaz T
AD  - Department of Pediatrics, Mayo Clinic, Rochester, MN, USA. Electronic address: 
      niaz.talha@mayo.edu.
FAU - Allison, Thomas G
AU  - Allison TG
AD  - Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. 
      Electronic address: allison.thomas@mayo.edu.
FAU - Johnson, Jonathan N
AU  - Johnson JN
AD  - Division of Pediatric Cardiology, Mayo Clinic, Rochester, MN, USA. Electronic 
      address: johnson.jonathan@mayo.edu.
FAU - Poterucha, Joseph T
AU  - Poterucha JT
AD  - Division of Pediatric Cardiology, Mayo Clinic, Rochester, MN, USA.
FAU - Said, Sameh M
AU  - Said SM
AD  - Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA. Electronic 
      address: said.sameh@mayo.edu.
FAU - Ammash, Naser M
AU  - Ammash NM
AD  - Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. 
      Electronic address: ammash.naser@mayo.edu.
LA  - eng
PT  - Journal Article
DEP - 20160628
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cohort Studies
MH  - Exercise Test/*methods/mortality/trends
MH  - Female
MH  - Fontan Procedure/*methods/mortality/trends
MH  - Heart Bypass, Right/mortality/trends
MH  - Humans
MH  - Male
MH  - Oxygen Consumption/physiology
MH  - Perioperative Care/*methods/mortality/trends
MH  - Retrospective Studies
MH  - Survival Rate/trends
MH  - Time Factors
MH  - Young Adult
OTO - NOTNLM
OT  - Cardiopulmonary exercise test
OT  - Exercise capacity
OT  - Fontan conversion
EDAT- 2016/07/09 06:00
MHDA- 2017/08/30 06:00
CRDT- 2016/07/09 06:00
PHST- 2016/05/06 00:00 [received]
PHST- 2016/06/23 00:00 [revised]
PHST- 2016/06/25 00:00 [accepted]
PHST- 2016/07/09 06:00 [entrez]
PHST- 2016/07/09 06:00 [pubmed]
PHST- 2017/08/30 06:00 [medline]
AID - S0167-5273(16)31217-7 [pii]
AID - 10.1016/j.ijcard.2016.06.209 [doi]
PST - ppublish
SO  - Int J Cardiol. 2016 Oct 1;220:564-8. doi: 10.1016/j.ijcard.2016.06.209. Epub 2016 
      Jun 28.