# Hypoplastic Left Heart Syndrome — GCMD Library living collection

Everything in the library about hypoplastic left heart syndrome — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 56 cited statements

## Episodes
### Evidence & Research
- [Outcomes of Fontan Patients Undergoing Combined Heart - Liver Transplantation in Pediatric Hospitals Across the U.S.](https://origin-library.globalcastmd.com/watch/outcomes-of-fontan-patients-undergoing-combined-heart-liver-transplantation-in-p-11307) — video · 0:59 · [machine version](https://origin-library.globalcastmd.com/watch/outcomes-of-fontan-patients-undergoing-combined-heart-liver-transplantation-in-p-11307.md)

### Case-Based Learning
- [Trans-Catheter Interventions: New Horizons in Medical and Surgical Fontan...](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893) — video · 17:26 · [machine version](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893.md)

### In-Depth Reviews
- [How Does the Blood Go Round in Single Ventricles and Fontans? New Horizons in...](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896) — video · 24:58 · [machine version](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896.md)

## Chapters
- [0:00](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=0) Introduction and Case Presentation: Plastic Bronchitis (Ep 1)
- [1:48](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=108) Plastic Bronchitis Pathophysiology and Catheterization Findings (Ep 1)
- [4:09](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=249) Fenestration Creation Technique and Outcome (Ep 1)
- [6:31](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=391) Conduit and Pulmonary Artery Obstruction Management (Ep 1)
- [8:09](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=489) Venous Obstruction and Lymphatic Considerations (Ep 1)
- [9:31](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=571) Conclusions and Multidisciplinary Approach (Ep 1)
- [10:55](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=655) Discussion: Management of Small Fontan Conduits (Ep 1)
- [13:33](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=813) Fluid Challenge Protocol (Ep 1)
- [14:49](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=889) Discussion: Conduit Dilation Limits and Technical Considerations (Ep 1)
- [0:00](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=0) Introduction and respiratory-driven flow in Fontan circulation (Ep 2)
- [4:01](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=241) Pulmonary vascular resistance and nitric oxide responsiveness (Ep 2)
- [6:10](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=370) Systemic right ventricle as non-risk factor and ventricular hypercontractility (Ep 2)
- [9:29](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=569) Diastolic dysfunction: impaired relaxation and reduced compliance (Ep 2)
- [16:28](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=988) Panel discussion: exercise, ventricular morphology, and diastolic pathophysiology (Ep 2)
- [0:00](https://origin-library.globalcastmd.com/watch/outcomes-of-fontan-patients-undergoing-combined-heart-liver-transplantation-in-p-11307?t=0) Combined Heart-Liver Transplant Outcomes in Fontan Patients (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- Fontan-associated plastic bronchitis occurs in less than 2% of patients with Fontan circulation — Brian (epidemiological) [Ep 1 · 1:56](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=116)
- Plastic bronchitis is characterized by proteinaceous lymphatic effluent into the tracheobronchial tree where there are connections between the lymphatic circulation and the airway — Brian (clinical) [Ep 1 · 2:01](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=121)
- With evaporation of water content through breathing, characteristic fibrinous airway casts remain and may be expectorated in whole or in part — Brian (clinical) [Ep 1 · 2:09](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=129)
- The incidence of fenestration thrombosis or stenosis early after the procedure and in short and mid-term follow-up is very high with bare metal stents, presumably from tissue invagination through the cells of the stent and tissue factor exposure to blood — Brian (clinical) [Ep 1 · 5:16](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=316)
- Even on anticoagulation, thrombosis is pretty common with bare metal stents used for fenestration creation — Brian (clinical) [Ep 1 · 5:34](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=334)
- Good procedures don't always mean much - one can do a good intervention in a complex population but it doesn't always mean you're going to change the ultimate clinical outcome — Brian (opinion) [Ep 1 · 5:46](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=346)
- The Fontan population has a very high incidence of liver-related pathologies — Brian (epidemiological) [Ep 1 · 6:51](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=411)
- Having obstruction in the inferior limb of the Fontan can be a real problem as it only serves to augment venous hypertension — Brian (clinical) [Ep 1 · 7:09](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=429)
- A resting absence of gradient does not rule out the presence of hemodynamically meaningful obstruction — Brian (clinical) [Ep 1 · 7:13](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=433)
- Left innominate vein obstruction can create opportunity for patients to present with either plastic bronchitis or protein-losing enteropathy, two diagnoses associated with very adverse clinical outcomes that have been shown increasingly to be associated with lymphatic pathology, especially by the group from Philadelphia — Brian (clinical) [Ep 1 · 8:37](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=517)
- Secondary palliations (palliation of a palliation, the Fontan circuit) have limitations - they may not offer cure, may not even offer substantial benefits — Brian (opinion) [Ep 1 · 9:47](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=587)
- Sometimes we're not able to test the hypothesis until we actually perform the intervention — Brian (opinion) [Ep 1 · 9:57](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=597)
- The approach to transcatheter interventions must be taken from a multidisciplinary perspective - therapies have both medical and surgical considerations to future therapies, to the need for anticoagulation — Brian (opinion) [Ep 1 · 10:03](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=603)
- Everything we do can have sequelae - it's really important to make sure that the multiple disciplines we use to care for these patients all understand and appreciate the implications of decision making and therapies — Brian (opinion) [Ep 1 · 10:38](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=638)
- Stent in conduit equals thrombogenic behavior substrate — Brian (clinical) [Ep 1 · 12:59](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=779)
- A 12-year-old young man being on Coumadin is not free (not without consequences) — Brian (opinion) [Ep 1 · 13:05](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=785)
- Having seen many of these patients grow up and face symptoms increasing through their teenage years, it's worth being aggressive when there's anatomic deficiencies within the circuit — Brian (opinion) [Ep 1 · 13:18](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=798)
- The fluid challenge protocol involves giving 15 cc per kilo with no limit of fluid volume rapidly via central access in about 2 minutes, then starting a timer with 5 minutes from the end of fluid challenge until repeat hemodynamic runs are measured — Brian (clinical) [Ep 1 · 13:59](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=839)
- Fluid challenge is not performed if patients have overt diastolic dysfunction, defined as baseline EDP at resting EDP of greater than 15 — Brian (clinical) [Ep 1 · 14:19](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=859)
- Fluid challenge is not performed if patients have baseline Fontan pressure greater than 18 and/or repeated hospitalizations with heart failure to get volume off — Brian (clinical) [Ep 1 · 14:30](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=870)
- We can safely take Gore-Tex tubes to at least 110% of their nominal diameter — Brian (clinical) [Ep 1 · 15:23](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=923)
- Beyond 110% of nominal diameter, there is a bit of risk, but the risk is probably pretty subtle for moderate dilation (e.g., 18mm tube to 22mm) — Brian (opinion) [Ep 1 · 15:31](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=931)
- There is always risk at the anastomosis where it's hard to necessarily cover that should a problem arise because hepatic vein enters very close — Brian (clinical) [Ep 1 · 15:44](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=944)
- Gore-Tex tubes can be taken up to about 110% - the stiffness constant is very high and you cannot generate enough pressure in the balloon to stretch the Gore-Tex much more than about 110% (clinical) [Ep 1 · 16:06](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=966)
- The risk of rupture is actually very low when dilating Gore-Tex conduits (opinion) [Ep 1 · 16:17](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=977)
- There are few patients who have an undersized tube at placement and really require augmentation of the nominal diameter — Brian (epidemiological) [Ep 1 · 16:32](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=992)
- Extracardiac conduits are three-dimensional structures that are not circular - if a 22mm tube measures 17mm in the frontal plane, it often measures 25mm in the lateral plane, and the cross-sectional area is just fine — Brian (clinical) [Ep 1 · 17:01](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=1021)
- It's important that there's a true stenosis, not just a non-circular shape, for us to want to treat conduit narrowing — Brian (opinion) [Ep 1 · 17:19](https://origin-library.globalcastmd.com/watch/trans-catheter-interventions-new-horizons-in-medical-and-surgical-fontan-893?t=1039)
- 40-50% of cardiac output at baseline in Fontan patients is driven directly by the work of breathing — Andrew Reddington (clinical) [Ep 2 · 2:43](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=163)
- Negative mean airway pressure during normal ventilation draws blood into the Fontan circuit — Andrew Reddington (clinical) [Ep 2 · 3:14](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=194)
- Valsalva maneuver with mean airway pressure elevated to 20 cm H2O cuts off spontaneous respiratory flow, leaving only tiny flow with ventricular systole — Andrew Reddington (clinical) [Ep 2 · 3:25](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=205)
- Low pulmonary vascular resistance is a prerequisite for good Fontan outcome — Andrew Reddington (clinical) [Ep 2 · 4:01](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=241)
- In normal individuals, nitric oxide does not reduce pulmonary vascular resistance because the pulmonary vascular bed is maximally vasodilated — Andrew Reddington (clinical) [Ep 2 · 4:52](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=292)
- Nitric oxide produced a statistically and physiologically significant fall in pulmonary vascular resistance of about 1 index wood unit in teenage Fontan patients — Andrew Reddington (clinical) [Ep 2 · 5:01](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=301)
- Only half of teenage Fontan patients showed benefit from nitric oxide — Andrew Reddington (clinical) [Ep 2 · 5:39](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=339)
- If only half of Fontan patients benefit from nitric oxide, they are unlikely to further benefit from PDE5 inhibitors — Andrew Reddington (opinion) [Ep 2 · 6:00](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=360)
- The systemic ventricle in Fontan circulation is hypercontractile to match its increased afterload — Andrew Reddington (clinical) [Ep 2 · 8:22](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=502)
- Arterial elastance is high in Fontan patients but relatively well coupled to ventricular elastance — Andrew Reddington (clinical) [Ep 2 · 9:29](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=569)
- The primary problem in Fontan ventricles is in diastole, not systole — Andrew Reddington (clinical) [Ep 2 · 9:29](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=569)
- In early post-Fontan course, it is early diastole (E wave) that is affected, not late diastole (A wave), with virtual abolishment of early rapid filling — Andrew Reddington (clinical) [Ep 2 · 10:14](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=614)
- Time constant of relaxation and isovolumic relaxation time are prolonged in early post-Fontan patients, indicative of impaired relaxation — Andrew Reddington (clinical) [Ep 2 · 10:43](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=643)
- Impaired early relaxation is due to incoordinate wall motion during isovolumic relaxation, with post-systolic shortening of one part of the ventricle causing another part to move outward — Andrew Reddington (clinical) [Ep 2 · 10:56](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=656)
- Longer isovolumic relaxation time correlates with longer hospital stay immediately after Fontan operation — Andrew Reddington (clinical) [Ep 2 · 12:23](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=743)
- Late post-Fontan patients can develop pseudonormalized filling pattern (E > A) due to rising left atrial pressure despite persistent incoordinate relaxation — Andrew Reddington (clinical) [Ep 2 · 13:03](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=783)
- In normal individuals, left ventricular end-diastolic pressure rises by about 2 mmHg per decade after age 30 — Andrew Reddington (clinical) [Ep 2 · 13:36](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=816)
- Fontan patients with high diastolic stiffness may have low end-diastolic pressure because reduced preload causes the ventricle to become smaller and pressure to fall down the pressure-volume curve — Andrew Reddington (clinical) [Ep 2 · 15:33](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=933)
- Bench pressing 500 pounds essentially cuts off pulmonary blood flow in Fontan patients — Andrew Reddington (clinical) [Ep 2 · 17:37](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=1057)
- Sustained Valsalva maneuvers may be particularly disadvantageous in old atrio-pulmonary Fontans due to direct effects on atrial stretch and potential for chronic atrial arrhythmias — Andrew Reddington (opinion) [Ep 2 · 18:13](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=1093)
- Mayo Clinic series with longer follow-up suggests right ventricular morphology does appear to be a risk factor late after Fontan (epidemiological) [Ep 2 · 19:32](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=1172)
- Rise in end-diastolic pressure in normal individuals is more rapid with hypertension, diabetes, other risk factors, and ventricular volume load such as AV valve or aortic regurgitation — Andrew Reddington (clinical) [Ep 2 · 21:58](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=1318)
- Fontan patients frequently have some degree of volume load and have had volume load for the first few years of life — Andrew Reddington (clinical) [Ep 2 · 22:33](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=1353)
- All Fontan patients have very raised arterial impedance and systemic vascular resistance — Andrew Reddington (clinical) [Ep 2 · 22:44](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=1364)
- There is no evidence-based role for ACE inhibition or arterial vasodilators in short-term Fontan management, as systemic vasodilation drops cardiac output — Andrew Reddington (opinion) [Ep 2 · 23:18](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=1398)
- Management of left ventricular end-diastolic pressure, fibrosis, and vascular biology have real potential as therapeutic targets in long-term Fontan management — Andrew Reddington (opinion) [Ep 2 · 23:38](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=1418)
- Understanding the impact of long-term therapies for diastolic dysfunction will require 10-20 years of follow-up — Andrew Reddington (opinion) [Ep 2 · 23:58](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=1438)
- The difference between 10-15 year outcomes and 20-30 year outcomes is important; abnormalities in diastolic relaxation will likely become clinically manifest later, and 30-year RV vs LV data are not yet available (opinion) [Ep 2 · 24:38](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=1478)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- CHOP data showed no difference in outcomes in the first 10 years after Fontan between hypoplastic left heart syndrome and systemic left ventricle patients — Andrew Reddington summarizing the discussion [Ep 2 · 6:54](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=414)
- Boston data showed patients born with systemic left ventricle with normally related great vessels or single right ventricle do better than all other diagnoses — Andrew Reddington summarizing the discussion [Ep 2 · 7:21](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=441)
- Melbourne group data showed right ventricular dominance is a risk factor if present at birth, but after surviving the first couple of years post-Fontan, survival curves are essentially identical regardless of ventricular morphology — Andrew Reddington summarizing the discussion [Ep 2 · 7:40](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=460)
- Force-frequency relationships in systemic right and left ventricles in univentricular circulation outperformed normal ventricles — Andrew Reddington summarizing the discussion [Ep 2 · 8:37](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=517)
- End-systolic elastance in Fontan patients is orders of magnitude higher than normals and even greater than in systemic right ventricle of Mustard patients — Andrew Reddington summarizing the discussion [Ep 2 · 9:03](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=543)
- MRI tagging showed some segments of Fontan ventricular wall were 180 degrees out of phase with other parts, in systole when rest of ventricle was in diastole — Andrew Reddington summarizing the discussion [Ep 2 · 11:58](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=718)
- Eight-year follow-up of Fontan patients showed maintained incoordinate relaxation, shortened IVRT suggesting rising left atrial pressure, and faster E wave deceleration suggesting falling compliance — Andrew Reddington summarizing the discussion [Ep 2 · 14:18](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=858)
- Diastolic compliance of Fontan ventricles (predominantly left ventricles) is highly abnormal, unlike Mustard systemic right ventricles where diastolic compliance is not a problem — Andrew Reddington summarizing the discussion [Ep 2 · 14:47](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=887)
- PHN data at 10-12 years post-Fontan showed systemic right ventricles had far more patients with increased E/E' ratio (indicating increased stiffness) compared to systemic left ventricles — Andrew Reddington summarizing the discussion [Ep 2 · 20:04](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=1204)
- Recent conductance catheter work from the Netherlands shows a tight relationship between arterial elastance and ventricular end-diastolic pressure — Andrew Reddington summarizing the discussion [Ep 2 · 23:01](https://origin-library.globalcastmd.com/watch/how-does-the-blood-go-round-in-single-ventricles-and-fontans-new-horizons-in-896?t=1381)
- More Fontan patients are surviving into adolescence and adulthood — Lizzie Lee summarizing a resource [Ep 3 · 0:11](https://origin-library.globalcastmd.com/watch/outcomes-of-fontan-patients-undergoing-combined-heart-liver-transplantation-in-p-11307?t=11)
- Liver disease is becoming a rising issue in Fontan patients — Lizzie Lee summarizing a resource [Ep 3 · 0:11](https://origin-library.globalcastmd.com/watch/outcomes-of-fontan-patients-undergoing-combined-heart-liver-transplantation-in-p-11307?t=11)
- Combined heart-liver transplantation is happening more often in Fontan patients — Lizzie Lee summarizing a resource [Ep 3 · 0:11](https://origin-library.globalcastmd.com/watch/outcomes-of-fontan-patients-undergoing-combined-heart-liver-transplantation-in-p-11307?t=11)
- The study examined children and young adults undergoing combined heart-liver transplant at hospitals across the US in the last few years — Lizzie Lee summarizing a resource [Ep 3 · 0:21](https://origin-library.globalcastmd.com/watch/outcomes-of-fontan-patients-undergoing-combined-heart-liver-transplantation-in-p-11307?t=21)
- Many of the patients in the study had hypoplastic left heart syndrome — Lizzie Lee summarizing a resource [Ep 3 · 0:28](https://origin-library.globalcastmd.com/watch/outcomes-of-fontan-patients-undergoing-combined-heart-liver-transplantation-in-p-11307?t=28)
- About 85% of patients survived at 1 year after combined heart-liver transplant — Lizzie Lee summarizing a resource [Ep 3 · 0:36](https://origin-library.globalcastmd.com/watch/outcomes-of-fontan-patients-undergoing-combined-heart-liver-transplantation-in-p-11307?t=36)
- Long-term outcomes after combined heart-liver transplant were excellent — Lizzie Lee summarizing a resource [Ep 3 · 0:36](https://origin-library.globalcastmd.com/watch/outcomes-of-fontan-patients-undergoing-combined-heart-liver-transplantation-in-p-11307?t=36)
- Three-year survival after combined heart-liver transplant was basically identical to patients who received heart transplant alone — Lizzie Lee summarizing a resource [Ep 3 · 0:41](https://origin-library.globalcastmd.com/watch/outcomes-of-fontan-patients-undergoing-combined-heart-liver-transplantation-in-p-11307?t=41)
- Combined heart-liver transplant is effective for Fontan patients with advanced liver disease — Lizzie Lee summarizing a resource [Ep 3 · 0:48](https://origin-library.globalcastmd.com/watch/outcomes-of-fontan-patients-undergoing-combined-heart-liver-transplantation-in-p-11307?t=48)
- Combined heart-liver transplant is increasingly common for Fontan patients with advanced liver disease — Lizzie Lee summarizing a resource [Ep 3 · 0:48](https://origin-library.globalcastmd.com/watch/outcomes-of-fontan-patients-undergoing-combined-heart-liver-transplantation-in-p-11307?t=48)

## Changelog
- Sep 7: 3 items added automatically

---
Educational content from recorded physician discussions — not medical advice. Cite the canonical URL or the ?t= deep link. Policy: https://origin-library.globalcastmd.com/ai