Attard C, Monagle PT, d'Udekem Y, et al. - This study was sought to correlate long-term rates of cerebrovascular injury, thrombosis, bleeding, bone mineral density (BMD) and quality of life in people living with Fontan circulation receiving warfarin as compared to aspirin. Researchers conducted a multicentre study of a selected cohort from Australian and New-Zealand Fontan (ANZ) population. Individuals had undergone cerebral magnetic resonance imaging to diagnose the presence of cerebrovascular injury (n=84) and dual-energy x-ray absorptiometry to evaluate bone mineral density (BMD; n=120)). They evaluated bleeding (n=100) and quality of life (n=90) applying validated questionaries (WA-BAT and PedsQL, respectively). The results of this study demonstrated that cerebrovascular injury are frequent occurrences in the ANZ Fontan population regardless of thromboprophylaxis type. This study’s findings indicated that no advantage of long-term warfarin prophylaxis could be demonstrated over aspirin; nevertheless, consideration must be given to important clinical features such as cardiac function and lung function. Moreover, the relationship of decreased bone health in children on warfarin needs future mechanistic studies.