What role do DOACs play in patients with Fontan circulation?
The role of DOACs in patients with Fontan is less defined, and thus far, the published evidence is limited to small observational series. Given the lack of conclusive evidence on the safety of DOACs in the presence of the hepatic dysfunction and altered coagulation in patients who underwent Fontan palliation, warfarin should be considered the preferred oral anticoagulant regimen.