title: The Use and Misuse of ACE Inhibitors in Patients with Single Ventricle Physiology.
abstract: BACKGROUND
  There are no clear guidelines for the use of angiotensin-converting enzyme (ACE) inhibitors in patients with single ventricle physiology, especially after the Fontan procedure. Despite this, ACE inhibitors are widely prescribed within the single ventricle population.
  
  
  OBJECTIVE
  We decided to review the literature to better establish the efficacy of ACE inhibitors in the single ventricle population and summarise their indications.
  
  
  METHODS
  A review of the literature was conducted to identify relevant articles describing use of ACE inhibitors in single ventricle patients both before and after the Fontan procedure.
  
  
  RESULTS
  A search in the Ovid MEDLINE and Embase databases identified a total of 140 articles, of which 31 were deemed relevant to the review.
  
  
  CONCLUSIONS
  There is little published evidence supporting the use of ACE inhibitors in patients with single ventricle physiology. Based on the current literature, it is possible that ACE inhibitors are overprescribed in patients with single ventricle physiology. The coordination of large, prospective studies through initiatives such as the Australia and New Zealand Fontan Registry is necessary to guide the appropriate use of ACE inhibitors in the single ventricle population.
authors.affiliation: Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Vic, Australia; Murdoch Childrens Research Institute, Heart Research Group, Melbourne, Vic, Australia.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Wilson
authors.affiliation: Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Vic, Australia; Murdoch Childrens Research Institute, Heart Research Group, Melbourne, Vic, Australia; Department of Paediatrics, Faculty of Medicine, The University of Melbourne, Melbourne, Vic, Australia.
authors.forename: Ajay J
authors.initials: AJ
authors.lastname: Iyengar
authors.affiliation: Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Vic, Australia; Murdoch Childrens Research Institute, Heart Research Group, Melbourne, Vic, Australia; Department of Paediatrics, Faculty of Medicine, The University of Melbourne, Melbourne, Vic, Australia. Electronic address: yves.dudekem@rch.org.au.
authors.forename: Yves
authors.initials: Y
authors.lastname: d'Udekem
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D006331:Heart Diseases / Q000188:drug therapy / Q000503:physiopathology; D006352:Heart Ventricles / Q000002:abnormalities / Q000503:physiopathology; D006801:Humans; D008297:Male
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors
keywords: Angiotensin-converting enzyme inhibitors; Fontan procedure; Heart defects congenital; Heart single ventricle; Heart ventricles abnormalities