Considerations for Advanced Heart Failure Consultation in Individuals With Fontan Circulation: Recommendations From ACTION.
Adam M LubertAri M CedarsChristopher S AlmondShahnawaz AmdaniJennifer ConwayJoshua M Friedland-LittleRobert J GajarskiSteven J KindelAngela LortsDavid L S MoralesMatthew J O'ConnorDavid M PengDavid N RosenthalLauren SmythDavid L SutcliffeKurt R SchumacherPublished in: Circulation. Heart failure (2023)
Individuals with Fontan circulation are at risk of late mortality from both cardiac and noncardiac causes. Despite the known risk of mortality, referral indications for advanced heart failure care vary between centers, and many individuals die from Fontan circulation-related complications either after late consideration for advanced heart failure therapies or having never seen a heart failure specialist. There is a critical need for guidelines to direct appropriately timed referral for advanced heart failure consultation. The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) Fontan Committee has developed recommended thresholds for advanced heart failure referral to guide primary cardiologists. These recommendations are divided into 4 categories of clinical Fontan circulatory dysfunction including (1) cardiac/systemic ventricular dysfunction, (2) Fontan pathway dysfunction, (3) lymphatic dysfunction, and (4) extracardiac dysfunction.
Keyphrases
- heart failure
- left ventricular
- palliative care
- oxidative stress
- acute heart failure
- cardiac resynchronization therapy
- primary care
- healthcare
- risk factors
- atrial fibrillation
- cardiovascular events
- lymph node
- type diabetes
- clinical practice
- metabolic syndrome
- extracorporeal membrane oxygenation
- chronic pain
- skeletal muscle