Surveillance and Screening of the Fontan Patient Survey

Question Title

* 1. What is the name of your institution or practice?

Other (please specify)

Question Title

* 2. How many years have you been practicing cardiology? (not including fellowship training)

< 5 years

5-10 years

10-15 years

> 15 years

Question Title

* 3. How many Fontan patients are you currently following in your practice?

5-10

10-15

>15

Question Title

* 4. What is the median age of your Fontan cohort?

Most <12 years of age

Most 12-18 years of age

Most 19 years of age or above

Question Title

* 5. What is your primary cardiac specialty?

General pediatric cardiology

Adult congenital

Cardiac imaging (Fetal, CMR, echo)

Heart failure/Transplant

Electrophysiology

Cardiac Interventionalist

Other

N/A

Other (please specify)

	Locally available	Available within a 50 mile radius outside home institution	Not available within 50 miles
Bloodwork	Bloodwork Locally available	Bloodwork Available within a 50 mile radius outside home institution	Bloodwork Not available within 50 miles
Pulse oximetry	Pulse oximetry Locally available	Pulse oximetry Available within a 50 mile radius outside home institution	Pulse oximetry Not available within 50 miles
Electrocardiogram	Electrocardiogram Locally available	Electrocardiogram Available within a 50 mile radius outside home institution	Electrocardiogram Not available within 50 miles
Holter monitor	Holter monitor Locally available	Holter monitor Available within a 50 mile radius outside home institution	Holter monitor Not available within 50 miles
Echocardiogram	Echocardiogram Locally available	Echocardiogram Available within a 50 mile radius outside home institution	Echocardiogram Not available within 50 miles
Simple exercise stress testing without metabolic assessment	Simple exercise stress testing without metabolic assessment Locally available	Simple exercise stress testing without metabolic assessment Available within a 50 mile radius outside home institution	Simple exercise stress testing without metabolic assessment Not available within 50 miles
Exercise stress testing with metabolic assessment	Exercise stress testing with metabolic assessment Locally available	Exercise stress testing with metabolic assessment Available within a 50 mile radius outside home institution	Exercise stress testing with metabolic assessment Not available within 50 miles
Cardiac catheterization	Cardiac catheterization Locally available	Cardiac catheterization Available within a 50 mile radius outside home institution	Cardiac catheterization Not available within 50 miles
Cardiac MRI	Cardiac MRI Locally available	Cardiac MRI Available within a 50 mile radius outside home institution	Cardiac MRI Not available within 50 miles
Sleep study	Sleep study Locally available	Sleep study Available within a 50 mile radius outside home institution	Sleep study Not available within 50 miles
Pulmonary function testing	Pulmonary function testing Locally available	Pulmonary function testing Available within a 50 mile radius outside home institution	Pulmonary function testing Not available within 50 miles
Abdominal ultrasound	Abdominal ultrasound Locally available	Abdominal ultrasound Available within a 50 mile radius outside home institution	Abdominal ultrasound Not available within 50 miles
Hepatology specialist consultation	Hepatology specialist consultation Locally available	Hepatology specialist consultation Available within a 50 mile radius outside home institution	Hepatology specialist consultation Not available within 50 miles
Neurodevelopmental specialist consultation	Neurodevelopmental specialist consultation Locally available	Neurodevelopmental specialist consultation Available within a 50 mile radius outside home institution	Neurodevelopmental specialist consultation Not available within 50 miles
Adult congenital heart disease provider	Adult congenital heart disease provider Locally available	Adult congenital heart disease provider Available within a 50 mile radius outside home institution	Adult congenital heart disease provider Not available within 50 miles

Locally available

Available within a 50 mile radius outside home institution

Not available within 50 miles

Bloodwork

Bloodwork Locally available

Bloodwork Available within a 50 mile radius outside home institution

Bloodwork Not available within 50 miles

Pulse oximetry

Pulse oximetry Locally available

Pulse oximetry Available within a 50 mile radius outside home institution

Pulse oximetry Not available within 50 miles

Electrocardiogram

Electrocardiogram Locally available

Electrocardiogram Available within a 50 mile radius outside home institution

Electrocardiogram Not available within 50 miles

Holter monitor

Holter monitor Locally available

Holter monitor Available within a 50 mile radius outside home institution

Holter monitor Not available within 50 miles

Echocardiogram

Echocardiogram Locally available

Echocardiogram Available within a 50 mile radius outside home institution

Echocardiogram Not available within 50 miles

Simple exercise stress testing without metabolic assessment

Simple exercise stress testing without metabolic assessment Locally available

Simple exercise stress testing without metabolic assessment Available within a 50 mile radius outside home institution

Simple exercise stress testing without metabolic assessment Not available within 50 miles

Exercise stress testing with metabolic assessment

Exercise stress testing with metabolic assessment Locally available

Exercise stress testing with metabolic assessment Available within a 50 mile radius outside home institution

Exercise stress testing with metabolic assessment Not available within 50 miles

Cardiac catheterization

Cardiac catheterization Locally available

Cardiac catheterization Available within a 50 mile radius outside home institution

Cardiac catheterization Not available within 50 miles

Cardiac MRI

Cardiac MRI Locally available

Cardiac MRI Available within a 50 mile radius outside home institution

Cardiac MRI Not available within 50 miles

Sleep study

Sleep study Locally available

Sleep study Available within a 50 mile radius outside home institution

Sleep study Not available within 50 miles

Pulmonary function testing

Pulmonary function testing Locally available

Pulmonary function testing Available within a 50 mile radius outside home institution

Pulmonary function testing Not available within 50 miles

Abdominal ultrasound

Abdominal ultrasound Locally available

Abdominal ultrasound Available within a 50 mile radius outside home institution

Abdominal ultrasound Not available within 50 miles

Hepatology specialist consultation

Hepatology specialist consultation Locally available

Hepatology specialist consultation Available within a 50 mile radius outside home institution

Hepatology specialist consultation Not available within 50 miles

Neurodevelopmental specialist consultation

Neurodevelopmental specialist consultation Locally available

Neurodevelopmental specialist consultation Available within a 50 mile radius outside home institution

Neurodevelopmental specialist consultation Not available within 50 miles

Adult congenital heart disease provider

Adult congenital heart disease provider Locally available

Adult congenital heart disease provider Available within a 50 mile radius outside home institution

Adult congenital heart disease provider Not available within 50 miles

Surveillance and Screening of the Fontan Patient

Cardiologist and Practice Information

Question Title

* 1. What is the name of your institution or practice?

Question Title

* 2. How many years have you been practicing cardiology? (not including fellowship training)

Question Title

* 3. How many Fontan patients are you currently following in your practice?

Question Title

* 4. What is the median age of your Fontan cohort?

Question Title

* 5. What is your primary cardiac specialty?

Question Title

* 6. What is the availability of testing and consultation?