Non‐Invasive Assessment of Endothelial Dysfunction and Arterial Stiffness in Fontan Circulation

Abstract

The Fontan procedure constitutes the definitive surgical strategy for complex congenital heart disease, establishing a circulation in which systemic venous blood is directed to the pulmonary arteries through a staged reconstruction that separates systemic and pulmonary venous return in the absence of a subpulmonary ventricle. This uniquely altered haemodynamic state exerts deleterious effects on endothelial function, thereby promoting progressive end‐organ dysfunction and contributing substantially to the long‐term morbidity observed in patients with Fontan circulation.