Association of Digoxin Use at Norwood Discharge with Fontan Completion: A Study from the Pediatric Heart Network Public Dataset

The study examined the impact of digoxin administered at discharge after the Norwood procedure on long-term outcomes in congenital heart disease. The research included 549 children from 15 North American centers between 2005 and 2008. Patients discharged on digoxin had a higher 6-year cumulative incidence of Fontan completion (82% versus 71%, p = 0.013). Competing risk analysis showed a 30% greater likelihood of Fontan completion in digoxin users (aHR 1.31; 95% CI 1.09-1.58; p = 0.005). However, no significant difference in transplant-free survival was found between groups. Digoxin administered after the second stage of the procedure was not associated with improved outcomes. The results suggest that digoxin at Norwood discharge may facilitate progression through the staged palliation procedure.