A NOVEL clinical risk score, the Fontan Adult Brompton (FAB) score, accurately predicts mortality and transplantation risk in adults with Fontan circulation, according to a study published in the European Heart Journal.
The retrospective study, conducted at a single tertiary centre, included 230 adult Fontan patients with a median age of 21.7 years. Over a 10.2-year follow-up, 44 patients died and two underwent heart transplantation. The researchers developed a risk score based on six readily available clinical variables:
- Age at first adult visit
- History of atrial tachyarrhythmia
- Heart failure history
- New York Heart Association class
- Systolic blood pressure
- Resting arterial oxygen saturation
The FAB score demonstrated good discriminative ability (C-index: 0.71) in stratifying patients into low, intermediate, and high-risk groups for death or transplantation. Importantly, the score showed excellent performance (C-index: 0.92) when externally validated in a cohort of 80 patients.
This externally validated clinical score offers a valuable tool for identifying high-risk Fontan patients early in adulthood, potentially enabling more personalized care and timely interventions in this complex congenital heart disease population.
Reference
Montanaro C et al. The Fontan Adult Brompton clinical score and mortality risk. European Heart Journal. 2025;ehaf137.
