Abstract 2008: Coil Embolization of Aortopulmonary Collaterals Prior to Fontan Completion is Not Associated With Functional Outcomes After the Fontan Procedure: A Report From the Pediatric Heart Network (PHN) Fontan Cross-Sectional Study

Background: The practice of coiling aortopulmonary collateral arteries (APC) before the Fontan procedure is controversial. We sought to compare outcomes in patients (pts) with and without pre-Fontan coil embolization of APCs using the PHN Cross-Sectional Fontan Study database. Methods: We compared hospital length of stay (LOS) after Fontan in pts who did (“coil group,” n=80) vs did not (“no coil group”, n=459) undergo APC coiling. Information on APC size and number was not available. Secondary outcomes included complications after Fontan and testing at cross-sectional follow-up. Patients requiring Fontan conversion (7) were excluded. Univariate methods and multivariate regression, adjusting for potential confounders, were used to compare outcomes. Results: The 7 PHN centers varied markedly in frequency of pre-Fontan APC coiling (range 0 –30%, p Conclusion: Management of APCs before Fontan shows marked practice variation. In this retrospective analysis, pre-Fontan coiling of APCs was associated neither with faster postoperative recovery nor with better late outcomes. Because we cannot exclude residual confounding, a randomized clinical trial of this practice is needed.