Page 228 - Read Online

Wang-Giuffre et al. Vessel Plus 2022;6:29 Vessel Plus
DOI: 10.20517/2574-1209.2021.98

Review Open Access

Cardiopulmonary exercise test as a tool in

surveillance after Fontan operation

Elizabeth W. Wang-Giuffre, Unnati H. Doshi
Pediatric Cardiology, University of Texas Health Science Center, McGovern Medical School, Children’s Memorial Hermann
Hospital, Houston, TX 77030, USA.

Correspondence to: Elizabeth W. Wang-Giuffre, Pediatric Cardiology, University of Texas Health Science Center, McGovern
Medical School, Children’s Memorial Hermann Hospital, 6410 Fannin Ste 370 Houston, Houston, TX 77030, USA.
E-mail: elizabeth.w.wang@uth.tmc.edu
How to cite this article: Wang-Giuffre EW, Doshi UH. Cardiopulmonary exercise test as a tool in surveillance after Fontan
operation. Vessel Plus 2022;6:29. https://dx.doi.org/10.20517/2574-1209.2021.98
Received: 6 Jul 2021 First Decision: 6 Sep 2021 Revised: 13 Oct 2021 Accepted: 18 Nov 2021 Published: 13 May 2022

Academic Editors: Jawahar L. Mehta, P Syamasundar Rao Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Fontan patients have significantly decreased exercise tolerance secondary to several factors, most notably, a lack
of a subpulmonary pump to augment systemic venous return to the heart and to overcome the pulmonary vascular
resistance. Cardiopulmonary exercise testing is an important inexpensive non-invasive tool to monitor for
subclinical changes and functional data over time that may portend the need for earlier intervention.

Keywords: Fontan, cardiopulmonary exercise test, fontan outcomes, oxygen consumption, oxygen uptake
efficiency slope, anaerobic threshold

INTRODUCTION
The Fontan operation was first performed in the early 1970s to palliate functionally single ventricle
patients . It has gone through many iterations and has been fraught with complications such as liver
[1]
[2]
fibrosis, plastic bronchitis, protein-losing enteropathy, and arrhythmia . Subsequent surgical technique
modifications and closer monitoring have improved outcomes; however, surveillance of complications
continues to be highly variable between institutions.

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

www.vpjournal.net