Open Access
ARTICLE
Effects of persistent Fontan fenestration patency on cardiopulmonary exercise testing variables
M. Elisabeth Heal1, Lanier B. Jackson2, Andrew M. Atz2, Ryan J. Butts3
1 Children’s Hospital of Philadelphia,
Department of Pediatrics, Division of
Cardiology, Philadelphia, PA 19104, USA
2 Department of Pediatrics, Division of
Cardiology, Medical University of South
Carolina, Charleston, SC 29425
3 Department of Pediatrics, Division of
Cardiology, University of Texas
Southwestern, Dallas, TX 75235
* Corresponding Author: Elisabeth Heal, 3401 Civic Center Blvd, Philadelphia PA 19104. Email:
Congenital Heart Disease 2017, 12(4), 399-402. https://doi.org/10.1111/chd.12451
Abstract
Cardiopulmonary exercise testing (CPET) aids in clinical assessment of patients with Fontan circulation.
Effects of persistent fenestration on CPET variables have not been clearly defined. Associations
between fenestration and CPET variables at anaerobic threshold (AT) and peak exercise were explored
in the Pediatric Heart Network Fontan Cross-Sectional Study cohort. Fenestration patency was associated with a greater decrease in oxygen saturation from rest to peak exercise (fenestration -4.9 ±
3.8 v. nonfenestration -3 ± 3.5; P < .001). Physiological dead space at peak exercise was higher in
fenestrated v. nonfenestrated (25.2 ± 16.1 v. 21.4 ± 15.2; P = .03). There was a weak association
between fenestration patency and maximal work and heart rate. Fenestration patency was also
weakly correlated with oxygen pulse, work and VE/VCO2 at AT. The effect of persistent fenestration
on CPET measurements was minimal in this study, likely due to the cross-sectional design.
Keywords
Cite This Article
Heal, M. E., Jackson, L. B., Atz, A. M., Butts, R. J. (2017). Effects of persistent Fontan fenestration patency on cardiopulmonary exercise testing variables.
Congenital Heart Disease, 12(4), 399–402. https://doi.org/10.1111/chd.12451