Moving on up: is it safe for patients to relocate to higher altitude following the fontan procedure?
The change in clinical status of patients status post-Fontan surgery who relocated from low (<1,500 feet) to moderate (>4,000 feet) altitude was assessed. Cardiology databases were queried for patients meeting inclusion criteria. The clinical records of these patients for the 6 months before and 6 months after relocation were then reviewed. Between 1990 and 2010, 16 patients relocated to moderate altitude. All patients developed a new cardiac-related adverse event within 6 months of relocation. A decrease in New York Heart Association functional classification occurred in 15 (94 %) patients, and 11 (69 %) of these required hospitalization. Clinical deterioration at higher altitude is common in patients who have undergone Fontan surgery. Physicians at lower altitudes should caution these patients about the potential risks of relocation to moderate altitude.
Department of Pediatrics, Division of Pediatric Cardiology, University of Utah, Salt Lake City, UT, 84113, USA. james.gottlieb@hsc.utah.edu
James L
JL
Gottlieb
William M
WM
McDonnell
Ronald W
RW
Day
Anji T
AT
Yetman
D000293:Adolescent; D000328:Adult; D000531:Altitude; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D012111:Residence Characteristics; D012189:Retrospective Studies