title: Clinical Profile and Quality of Life of Adult Patients After the Fontan Procedure.
abstract: Increasingly, more patients with univentricular heart reach adulthood. Therefore, long-term psychological features are an important concern. The aim of this study was to evaluate the clinical and psychological profile of post-Fontan adult patients and to identify the most significant determinants of quality of life. In this retrospective cross-sectional study, we reviewed the surgical and medical history of post-Fontan adult patients. Patients underwent a 24-h electrocardiogram, echocardiography and exercise testing. Self-report questionnaires were used to assess the Work Ability Index, quality of life (Satisfaction with Life Scale), perceived health status (SF-36 questionnaire), coping strategies (Brief Cope questionnaire) and presence of mood disorders (Hospital Anxiety and Depression Scale). Thirty-nine patients aged between 18 and 48 years (mean 27.5 years) were enrolled. The mean follow-up was 21.5 years. Most patients were unmarried (82.9 %), had a high school diploma (62.9 %) and were employed (62.9 %). Twenty-nine patients (82.3 %) had at least one long-term complication. The median single ventricle ejection fraction was 57 %, and the median maximal oxygen consumption was 26.8 ml/min/kg. This population tended to be anxious and to use adaptive coping strategies. Quality of life was perceived as excellent or good in 57.2 % of cases and was not related to either cardiac function or exercise capacity. Both quality of life and SF-36 domains were related to the Work Ability Index. This cohort of post-Fontan adult patients enjoyed a good quality of life irrespective of disease severity.
authors.affiliation: Pediatric Cardiology Unit, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy, giulia.bordin@gmail.com.
authors.forename: Giulia
authors.initials: G
authors.lastname: Bordin
authors.forename: Massimo Antonio
authors.initials: MA
authors.lastname: Padalino
authors.forename: Sonja
authors.initials: S
authors.lastname: Perentaler
authors.forename: Biagio
authors.initials: B
authors.lastname: Castaldi
authors.forename: Nicola
authors.initials: N
authors.lastname: Maschietto
authors.forename: Pierantonio
authors.initials: P
authors.lastname: Michieli
authors.forename: Roberto
authors.initials: R
authors.lastname: Crepaz
authors.forename: Anna Chiara
authors.initials: AC
authors.lastname: Frigo
authors.forename: Vladimiro Lorenzo
authors.initials: VL
authors.lastname: Vida
authors.forename: Ornella
authors.initials: O
authors.lastname: Milanesi
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test / Q000379:methods; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D011795:Surveys and Questionnaires; D055815:Young Adult
references.citation: J Pers Assess. 1985 Feb;49(1):71-5
references.pmid: 16367493
references.citation: Circulation. 1990 Nov;82(5):1681-9
references.pmid: 2225370
references.citation: J Am Coll Cardiol. 1995 Oct;26(4):1016-21
references.pmid: 7560594
references.citation: Ann Thorac Surg. 2009 Dec;88(6):1961-9
references.pmid: 19932269
references.citation: J Pediatr Surg. 2010 Nov;45(11):2146-53
references.pmid: 21034936
references.citation: Eur J Cardiothorac Surg. 2009 Jul;36(1):105-11; discussion 111
references.pmid: 19442530
references.citation: Int J Cardiol. 2009 Oct 2;137(2):158-64
references.pmid: 18707776
references.citation: Heart. 2002 Apr;87(4):356-62
references.pmid: 11907011
references.citation: J Thorac Cardiovasc Surg. 1990 Aug;100(2):228-32
references.pmid: 2143549
references.citation: Int J Cardiol. 2013 Sep 30;168(2):1458-65
references.pmid: 23333363
references.citation: Int J Behav Med. 1997;4(1):92-100
references.pmid: 16250744
references.citation: J Thorac Cardiovasc Surg. 1988 Nov;96(5):682-95
references.pmid: 3184963
references.citation: Am J Cardiol. 2002 Feb 1;89(3):276-80
references.pmid: 11809428
references.citation: Circulation. 2010 Nov 30;122(22):2264-72
references.pmid: 21098444
references.citation: Acta Psychiatr Scand. 1983 Jun;67(6):361-70
references.pmid: 6880820
references.citation: Eur Heart J. 2003 Jun;24(11):1035-84
references.pmid: 12868424
references.citation: Med Care. 1993 Mar;31(3):247-63
references.pmid: 8450681
references.citation: Cardiology. 2011;120(1):36-42
references.pmid: 22094965
references.citation: Heart. 2005 Jun;91(6):839-46
references.pmid: 15894794
references.citation: Heart. 2005 Sep;91(9):1193-8
references.pmid: 16103557
references.citation: J Cardiovasc Nurs. 2012 Nov-Dec;27(6):539-46
references.pmid: 21912272
references.citation: Heart. 2005 Apr;91(4):517-20
references.pmid: 15772218
references.citation: Heart. 2001 Jul;86(1):69-73
references.pmid: 11410565