Nutritional considerations for people living with a Fontan circulation: a narrative review.

Derek Tran, Melanie Clode, Julian Ayer, Suzie Ferrie, Rachael Cordina, Avik Majumdar

Journal: Cardiology in the young 2024;34(2):238-249

PMID: 38258459

Full Text on Ovid Technologies, Inc. View on PubMed

Abstract

The population of people living with a Fontan circulation are highly heterogenous, including both children and adults, who have complex health issues and comorbidities associated with their unique physiology throughout life. Research focused on nutritional considerations and interventions in the Fontan population is extremely limited beyond childhood. This review article discusses the current literature examining nutritional considerations in the setting of Fontan physiology and provides an overview of the available evidence to support nutritional management strategies and future research directions. Protein-losing enteropathy, growth deficits, bone mineral loss, and malabsorption are well-recognised nutritional concerns within this population, but increased adiposity, altered glucose metabolism, and skeletal muscle deficiency are also more recently identified issues. Emergencing evidence suggets that abnormal body composition is associated with poor circulatory function and health outcomes. Many nutrition-related issues, including the impact of congenital heart disease on nutritional status, factors contributing to altered body composition and comorbidities, as well as the role of the microbiome and metabolomics, remain poodly understood.

Address: The University of Sydney, Sydney Medical School, Camperdown, NSW, Australia.; Heart Research Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia.; The University of Sydney, Sydney Medical School, Camperdown, NSW, Australia.; Heart Research Institute, Newtown, NSW, Australia.; Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.; The University of Sydney, Sydney Medical School, Camperdown, NSW, Australia.; The University of Sydney, Sydney Medical School, Camperdown, NSW, Australia.; The Heart Centre for Children, The Sydney Children's Hospital Network, Westmead, NSW, Australia.; The University of Sydney, Sydney Medical School, Camperdown, NSW, Australia.; Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.; The University of Sydney, Sydney Medical School, Camperdown, NSW, Australia.; Heart Research Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia.; Heart Research Institute, Newtown, NSW, Australia.; Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.

DOI: 10.1017/S1047951123004389

Link outs

Free resources

Medical:

https://medlineplus.gov/congenitalheartdefects.htm...

Subscription / membership required

Full Text Sources:

MeSH Terms: Child, Adult, Humans, Fontan Procedure, Heart Defects, Congenital, Obesity, Protein-Losing Enteropathies, Nutritional Status