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\begin{document}

\title{National Fontan Operation outcomes at or below 2-years-of-age compared
to older than 2- years-of-age}



\author[1]{Sandeep Sainathan}%
\author[2]{Chris Agala}%
\author[3]{Sameh Said}%
\author[1]{Leonardo Mulinari }%
\author[2]{Mahesh Sharma}%
\affil[1]{University of Miami Department of Surgery}%
\affil[2]{University of North Carolina at Chapel Hill Libraries}%
\affil[3]{University of Minnesota Division of Cardiothoracic Surgery}%


\vspace{-1em}



  
  \date{June 11, 2024}


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\begin{abstract}
\textbf{Introduction}: Opinion is divided about optimal early timing of
the Fontan Operation (FO). While some studies have suggested 3
years-of-age, others have shown good outcomes below 2 years-of -age. We
analyzed the impact of age [?]2-years as compared age
\textgreater{}2-years on short-term outcome of the FO using a large
national database. \textbf{Methods}: A retrospective analysis of the
Kids Inpatient Database (2009-16) for the FO was done. The groups were
divided into those who underwent FO at age [?]2-years (EF) as compared to
age \textgreater{}2-years (LF). The data was abstracted for
demographics, clinical characteristics, and operative outcomes. Standard
statistical tests were used. \textbf{Results}: 3381 patients underwent
FO during this period of which 1482 (44\%) were EF. The mean ages of the
EF and LF were 1.6 and 4.3, respectively (p\textless{} 0.001). LF were
more likely to be non-White, female, and have Heterotaxy syndrome. HLHS
was more common in EF. There was no difference in the discharge
mortality, length of stay, disposition (majority went home), and mean
total charges incurred. The overall discharge mortality was low at 0.7\%
(24/3381). In multivariate analysis: cardiac arrest, acute kidney
injury, mechanical ventilation \textgreater{}96 hours, endocardial
cushion defect and non-White ethnicity were predictors of a mortality
and not age. \textbf{Conclusion}: Contemporary outcomes for FO are
excellent with equivalent short-term outcomes in both the age groups.
Occurrence of postoperative complications, non-white ethnicity and
endocardial cushion defect diagnosis were predictive of a negative
outcome.%
\end{abstract}%



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\textbf{Hosted file}

\verb`Fontan manuscript Final JOCS.docx`  available at \url{https://authorea.com/users/448755/articles/547489-national-fontan-operation-outcomes-at-or-below-2-years-of-age-compared-to-older-than-2-years-of-age}

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