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Congenital Heart Disease (CHD)NCT07535203

Fontan Outcomes in Oligemia vs Plethora in Univentricular CHD

An observational study of Congenital Heart Disease (CHD) and Univentricular Heart, run by Sisca Natalia Siagian at 1 site in Indonesia.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This prospective cohort study evaluates differences in clinical outcomes between pulmonary oligemia and pulmonary plethora in patients with cyanotic congenital heart disease and univentricular heart physiology undergoing staged palliation culminating in the Fontan procedure.Fifty-two patients will be classified into… Read more about this study

Who is it for?
Any age
What is being tested?
Fontan Procedure
Type of treatment
Surgery or procedure
How many people
52 participants
Where
1 siteIndonesia
Study dates
1 Jan 2025to Jun 2027
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: This study will involve a cohort of clinically diagnosed patients with univentricular heart physiology who are undergoing the Fontan procedure as their final intervention.

Who may be able to join

  • Diagnosed cyanotic CHD
  • Univentricular heart physiology
  • Planned staged palliation including Fontan procedure
  • Informed consent obtained (patient or guardian)

Who cannot join

  • Refusal to participate
  • Incomplete clinical data
  • Inability to complete follow-up

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Sisca Natalia Siagian, MD contact

+6281212716332

sisca.ped.car@gmail.com

Indonesia1 site, 1 recruiting
  • National Cardiovascular Center Harapan Kita

    Jakarta, DKI Jakarta, 11420

    Sisca Natalia Siagian, MD, +6281212716332, sisca.ped.car@gmail.com

    Recruiting

Other trials in Indonesia

About this study

Official title: Comparison of Outcomes of Pulmonary Oligemia Versus Pulmonary Plethora in Cyanotic Congenital Heart Disease With Univentricular Heart After Fontan Procedure

This prospective cohort study evaluates differences in clinical outcomes between pulmonary oligemia and pulmonary plethora in patients with cyanotic congenital heart disease and univentricular heart physiology undergoing staged palliation culminating in the Fontan procedure.Fifty-two patients will be classified into two groups based on pulmonary blood flow characteristics and followed for approximately 1.5 years after the Fontan procedure. Outcomes include mortality, morbidity, pulmonary hemodynamics, functional capacity, neurocognitive status, and quality of life.

Read the detailed description

Univentricular heart physiology represents a complex form of congenital heart disease requiring staged surgical palliation. The Fontan procedure has improved survival; however, outcomes remain variable and are influenced by pulmonary vascular conditions. Pulmonary blood flow abnormalities-oligemia (reduced flow) and plethora (increased flow)-may affect lung development from fetal life. Oligemia has been associated with pulmonary hypoplasia, impaired alveolar formation, and increased pulmonary vascular resistance, which may adversely affect Fontan circulation.

This prospective cohort study aims to compare outcomes between patients with oligemia and those with plethora. Participants will undergo standard clinical care, including staged procedures (Bidirectional Glenn and Fontan), and comprehensive assessments (clinical, laboratory, imaging, and hemodynamic). Follow-up will be conducted for approximately 1.5 years post-Fontan.

The study will evaluate mortality, morbidity, pulmonary hemodynamics, biomarkers (NT-proBNP, ET-1, Activin-A), exercise capacity, neurocognitive outcomes, and quality of life. Findings are expected to improve risk stratification and management strategies in univentricular CHD.

Being tested
Fontan Procedure
Keywords
univentricular heart, congenital heart disease, fontan procedure, pulmonary blood flow, oligemia, plethora, pulmonary hemodynamics
Medical subject headings
Heart Defects, Congenital, Univentricular Heart, Hypovolemia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Fontan ProcedureProcedure or surgery

    Standard staged palliation including Bidirectional Glenn and Fontan procedure. No experimental intervention; observational classification only.

Study groups in NCT07535203
Study groupRoleWhat they receive
Pulmonary OligemiaPatients with cyanotic CHD and univentricular physiology characterized by reduced pulmonary blood flow.
Receives: Procedure: Fontan Procedure
Pulmonary PlethoraPatients with cyanotic CHD and univentricular physiology characterized by increased pulmonary blood flow.
Receives: Procedure: Fontan Procedure

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mortality

    All-cause mortality following completion of Fontan procedure.

    Measured: From recruitment through study completion (an average of 1 year post-Fontan)

Secondary outcomes (17)
  1. Number of Participants with Postoperative Complications

    Assessment of postoperative morbidity defined as the occurrence of complications (e.g., arrhythmia, infection, thrombosis, or other clinically significant adverse events) following the Fontan procedure.

    Measurement Tool: Clinical assessment and medical record review Unit of Measure: Number of participants with ≥1 complication

    Measured: From Fontan procedure through study completion (up to 12 months post-Fontan)

  2. Number of Participants with Rehospitalization

    Assessment of rehospitalization defined as any unplanned hospital admission after discharge following the Fontan procedure.

    Measurement Tool: Medical record review Unit of Measure: Number of participants rehospitalized (≥1 admission)

    Measured: From hospital discharge post-Fontan through study completion (up to 12 months post-Fontan)

  3. Concentration of Activin-A in Blood

    Measurement of circulating Activin-A concentration as a biomarker of pulmonary vascular remodeling and inflammation in patients with univentricular congenital heart disease undergoing staged palliation. Blood samples will be collected at predefined perioperative time points.

    Measurement Tool:

    Enzyme-linked immunosorbent assay (ELISA) or equivalent validated immunoassay

    Unit of Measure:

    Picograms per milliliter (pg/mL)

    Measured: Baseline (pre-BCPS procedure), Perioperative at Stage II (Bidirectional Cavopulmonary Shunt [BCPS]), Perioperative at Stage III (Fontan procedure)

  4. Concentration of Activin-A in Pulmonary Artery Tissue

    Measurement of Activin-A concentration in pulmonary artery tissue obtained during surgical procedures, reflecting local vascular remodeling and inflammatory activity.

    Measurement Tool:

    Enzyme-linked immunosorbent assay (ELISA) or equivalent validated immunoassay on homogenized tissue samples

    Unit of Measure:

    Picograms per milligram of tissue (pg/mg)

    Measured: - At time of tissue collection during Stage II (Bidirectional Cavopulmonary Shunt [BCPS]) - At time of tissue collection during Stage III (Fontan procedure) Analysis performed within 1 month after each collection

  5. Distance Covered in Six-Minute Walk Test (6MWT)

    Assessment of functional exercise capacity using the six-minute walk test (6MWT), performed according to standardized protocol.

    Measurement Tool: Six-minute walk test (6MWT) Unit of Measure: Distance in meters (m) Interpretation: More distance covered means higher exercise capacity

    Measured: Follow-up (6 months post-Fontan procedure)

  6. Neurodevelopmental Score Using Bayley Scales of Infant and Toddler Development, Fourth Edition (BSID-IV)

    Assessment of neurocognitive and developmental function in pediatric patients using the Bayley Scales of Infant and Toddler Development, Fourth Edition (BSID-IV). The instrument evaluates multiple domains including cognitive, language (receptive and expressive), motor (fine and gross), social-emotional, and adaptive behavior. Raw scores are converted into standardized composite scores based on age-specific norms.

    Measurement Tool:

    Bayley Scales of Infant and Toddler Development, Fourth Edition (BSID-IV)

    Unit of Measure:

    Standard score (composite score), typically ranging from 40 to 160, with a mean of 100 and standard deviation of 15 Higher scores indicate better neurodevelopmental performance

    Measured: Follow-up (6 months post-Fontan procedure)

  7. Cognitive Function Score Using Montreal Cognitive Assessment (MoCA)

    Assessment of cognitive function in adult patients using the Montreal Cognitive Assessment (MoCA), a screening tool evaluating domains including memory, executive function, attention, language, visuospatial ability, and orientation.

    Measurement Tool:

    Montreal Cognitive Assessment (MoCA)

    Unit of Measure:

    Score on a scale from 0 to 30, where higher scores indicate better cognitive function; a score of 26 or above is considered normal

    Measured: Follow-up (6 months post-Fontan Procedure)

  8. Quality of Life Score Using Child Health Questionnaire (CHQ)

    Assessment of quality of life in pediatric patients using the Child Health Questionnaire (CHQ). The instrument evaluates multiple health domains, which are aggregated into Physical Health Summary (PhS) and Psychosocial Summary (PsS) scores.

    Measurement Tool: Child Health Questionnaire (CHQ) Unit of Measure: Score on a scale from 0 to 100 (higher scores indicate better health status)

    Measured: Follow-up (6 months post-Fontan procedure)

  9. Quality of Life Score Using 36-Item Short Form Survey (SF-36)

    Assessment of quality of life in adult patients using the 36-item Short Form Survey (SF-36). The instrument includes 8 domains aggregated into Physical Component Summary (PCS) and Mental Component Summary (MCS) scores.

    Measurement Tool: 36-item Short Form Survey (SF-36) Unit of Measure: Score on a scale from 0 to 100 (higher scores indicate better health status)

    Measured: Follow-up (6 months post-Fontan Procedure)

  10. Histopathological Score of Pulmonary Artery Remodeling Using Hematoxylin and Eosin (H&E) Staining

    Semi-quantitative assessment of pulmonary artery structural changes (e.g., medial hypertrophy, intimal proliferation, luminal narrowing) using Hematoxylin and Eosin (H\&E) staining. A standardized Pulmonary Artery Remodeling Histopathological Scoring System is used to grade the severity of vascular changes.

    Measurement Tool:

    Light microscopy using a semi-quantitative histopathological scoring system

    Unit of Measure:

    Score on a scale from 0 to 3, where:

    0 = no structural abnormality

    1. = mild remodeling
    2. = moderate remodeling
    3. = severe remodeling Higher scores indicate worse pulmonary artery remodeling

    Measured: At time of tissue collection during BCPS and Fontan procedures; analysis performed within 1 month after each collection

  11. Percentage of Collagen Deposition Using Masson's Trichrome Staining

    Quantification of collagen accumulation in pulmonary artery tissue using Masson's Trichrome staining, analyzed via digital image analysis software.

    Measurement Tool: Image analysis software (e.g., ImageJ or equivalent) Unit of Measure: Percentage (%) of stained area per total vessel area

    Measured: At time of tissue collection during BCPS and Fontan procedures; analysis performed within 1 month after each collection

  12. Elastin Density Measured by Verhoeff-Van Gieson (VVG) Staining

    Evaluation of elastin fiber integrity and distribution in pulmonary artery tissue using Elastica Van Gieson staining.

    Measurement Tool: Microscopy with image analysis Unit of Measure: Percentage (%) elastin-positive area

    Measured: At time of tissue collection during BCPS and Fontan procedures; analysis performed within 1 month after each collection

  13. Percentage of PAS-Positive Area in Pulmonary Artery Tissue

    Assessment of glycoprotein/glycogen and basement membrane components using Periodic Acid-Schiff (PAS) staining.

    Measurement Tool: Microscopy with quantitative image analysis Unit of Measure: Percentage (%) PAS-positive area

    Measured: At time of tissue collection during BCPS and Fontan procedures; analysis performed within 1 month after each collection

  14. Mean Pulmonary Artery Pressure Measured by Right Heart Catheterization

    Measurement of mean pulmonary artery pressure (mPAP) obtained from right heart catheterization to assess pulmonary hemodynamics.

    Measurement Tool: Right heart catheterization Unit of Measure: Millimeters of mercury (mmHg)

    Measured: Baseline, Post-BCPS preparing for Fontan (average of 3 months post-BCPS procedure), Follow-up (average of 6 months post-Fontan procedure)

  15. Pulmonary Vascular Resistance Measured by Right Heart Catheterization

    Calculation of pulmonary vascular resistance (PVR) derived from catheterization data using standard hemodynamic formulas.

    Measurement Tool: Right heart catheterization with hemodynamic calculation Unit of Measure: Wood units (WU)

    Measured: Baseline, Post-BCPS preparing for Fontan (average of 3 months post-BCPS procedure), Follow-up (average of 6 months post-Fontan procedure)

  16. McGoon Ratio Assessed by Angiography

    Evaluation of pulmonary artery size using the McGoon ratio, calculated as the sum of the diameters of the right and left pulmonary arteries divided by the diameter of the descending aorta, measured from angiographic images.

    Measurement Tool: Angiography with standardized measurement method Unit of Measure: Ratio (unitless)

    Measured: Baseline, Post-BCPS preparing for Fontan (average of 3 months post-BCPS procedure), Follow-up (average of 6 months post-Fontan procedure)

  17. Nakata Index Measured by Angiography

    Quantification of pulmonary artery size using the Nakata index, calculated as the sum of cross-sectional areas of the right and left pulmonary arteries normalized to body surface area.

    Measurement Tool: Angiography with body surface area calculation Unit of Measure: mm²/m²

    Measured: Baseline, Post-BCPS preparing for Fontan (average of 3 months post-BCPS procedure), Follow-up (average of 6 months post-Fontan procedure)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Apr 2026
  2. Study start1 Jan 2025
  3. Primary completion1 Mar 2027 (estimated)
  4. Study completionJun 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
52 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07535203
Sponsor's protocol ID
DP.04.03/D.XIII/6681/2025
Status last verified
Apr 2026
First submitted
27 Mar 2026
Last updated
17 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be publicly shared. Data may be available upon reasonable request to the principal investigator.

Questions about this trial

What is this clinical trial studying?

An observational study of Congenital Heart Disease (CHD) and Univentricular Heart, run by Sisca Natalia Siagian at 1 site in Indonesia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 17 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Indonesia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Sisca Natalia Siagian, MD (+6281212716332, sisca.ped.car@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mortality (time frame: From recruitment through study completion (an average of 1 year post-Fontan)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Apr 2026.

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