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Introduction:Some authors advocate the use of a dedicated formula to predict the Fontan pressure starting from pre-Fontan catheterisation data. This paper aims at testing the predictive value of the mentioned formula through a retrospective clinical study.Methods and Results:Pre-Fontan catheterisation data and Fontan pressure measured at the completion were retrospectively collected. Pre-Fontan data were used to calculate the predicted pressure in the Fontan system. The predicted values were compared to the Fontan pressure measured at the Fontan completion and with the needs for fenestration. One hundred twenty-four Fontan patients were retrospectively enrolled (At Fontan: median age 30.73 [24.70–37.20] months, median weight 12.00 [10.98–14.15] kg). Fontan conduit was fenestrated in 78 patients. A poor correlation (r2 = 0.05128) between the measured and predicted data for non-fenestrated patients was observed. In the case of Fontan-predicted pressure <17.59 mmHg, the formula identified a good short-term clinical outcome with a sensitivity of 92%.Conclusion:The proposed formula showed a poor capability in estimating the actual pressure into the Fontan system and in identifying patients needing fenestration. As the pressure into the Fontan system is determined by multiple factors, the tested formula could be an additional data in a multi-parametric approach.

Introduction: Among the factors which determine Fontan outcome, the total cavo-pulmonary pressure plays a fundamental role. Some authors advocate the use of a dedicated formula to predict the Fontan pressure. The aim of this work is to test the predictive and the clinical value of the mentioned formula through a retrospective clinical study. Methods: Data of all patients undergoing pre-Fontan catheterization and Fontan completion at our institution were collected. Pre-Fontan catheterization data were used to calculate the predicted Fontan pressure. Predicted values were compared to the pressure measured in the acute phase after the Fontan completion and correlated to patients’ clinical outcomes. Results: 124 Fontan patients were retrospectively enrolled with a median age at the Fontan of 35.00 [31.00- 41.25] months, median weight of 13.00 [11.68-14.10] Kg. Fontan conduct was fenestrated in 78 patients. Fontan failure (composite of death, need for transplant, takedown) was observed in 11. A statistically significant correlation between measured and predicted data for the overall population (p = 0.0114) but with a poor correlation coefficient (r2 = 0.014). In the case of Fontan predicted pressure lower than 17.59 mmHg, the formula was able to identify a good clinical outcome in the acute phase with a sensitivity of 92% and specificity of 31%. Conclusion: The proposed formula showed a poor capability in estimating the actual pressure into the Fontan system and in identifying patients needing fenestration. However, a cut-off value lower than 17.59 mmHg showed a fair sensitivity to identify patients with a good acute clinical outcome.