Fontan operation after 3 decades: what we have learned.

  title={Fontan operation after 3 decades: what we have learned.},
  author={Welton M. Gersony},
  volume={117 1},
The Fontan operation was designed to provide blood flow in series to the pulmonary and systemic circulation without the requirement for a right ventricular pumping chamber. The operation allows systemic venous blood to flow directly into the pulmonary circulation on the basis of a single ventricular impetus through the arteries, capillaries, and systemic venous system. This arrangement has improved life expectancy for patients with single-ventricle and pulmonary-outflow obstruction compared… 

The Fontan Procedure: Now What?

The outcome of patients with the Fontan circulation continues to be concerning as unique complications plague these patients, such as heart failure with preserved ventricular contractility, thromboembolism, protein-losing enteropathy, and liver failure.

Posterior Circulation Ischemia or Occlusion in Five Adults With Failing Fontan Circulation.

Total cavopulmonary connection with a new restorative vascular graft: results at 2 years

The results suggest that complete transformation of a bioabsorbable polymer and replacement through endogenous tissue may represent a major advantage in the treatment of congenital heart disease patients.

The adult with Fontan physiology: systematic approach to perioperative management for noncardiac surgery.

Although it is recommended that adults with Fontan physiology be managed at centers with cardiac anesthesiologists and cardiologists who specialize in the care of the adult with congenital heart disease, emergency situations may preclude safe transport to such centers.

Statistical Shape Modeling for Cavopulmonary Assist Device Development: Variability of Vascular Graft Geometry and Implications for Hemodynamics.

Patients born with a single functional ventricle typically undergo three-staged surgical palliation in the first years of life, with the last stage realizing a cross-like total cavopulmonary

Pulsatile blood flow in total cavopulmonary connection: a comparison between Y-shaped and T-shaped geometry

Through the use of Computational Fluid Dynamics, T-shaped (MRI-based) and Y- shaped (computer-generated) geometries are compared in order to determine the influence of this modification on pulsation of blood flow as well as energy loss in pulmonary arteries, and results indicate thatEnergy loss in Y-shaped geometry is far less than T- shaped geometry, while the difference in flow pulsatility is insignificant.

Five decades of the Fontan operation: A systematic review of international reports on outcomes after univentricular palliation

Patients palliated for complex univentricular heart malformations nowadays benefit from the experience and technical developments of the past decades and have a significantly improved long-term prognosis, however, important issues concerning postoperativelong-term morbidity and mortality are still unsolved and clear intrinsic limitations of the Fontan circulation are becoming evident as the population of Fontan patients ages.

Mechanical Circulatory Support of a Univentricular Fontan Circulation with a Continuous Axial-Flow Pump in a Piglet Model

A continuous axial-flow pump was used to support a univentricular Fontan circulation to serve as a “bridge” to heart transplantation or recovery in patients with complex congenital heart diseases.



Influence of ventricular morphology on outcome after the Fontan procedure.

Long-Term Survival, Modes of Death, and Predictors of Mortality in Patients With Fontan Surgery

In perioperative survivors of Fontan surgery, gradual attrition occurs predominantly from thromboembolic, heart failure–related, and sudden deaths.

Thromboembolic problems after the Fontan operation.

  • P. MonagleT. Karl
  • Medicine
    Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual
  • 2002
There is insufficient evidence to make clear recommendations about optimal anticoagulant prophylaxis at this time, and Multicenter randomized controlled trials comparing prophyllactic antiplatelet with anticoAGulation therapies are needed to provide rational scientific guidelines for future management of Fontan patients.

Relationship of Patient and Medical Characteristics to Health Status in Children and Adolescents After the Fontan Procedure

There are deficits in health status in children and adolescents after the Fontan procedure, and strategies to address this problem might emphasize coordinated and effective prevention, detection, and management of noncardiac and psychosocial conditions, as well as specific targeting of patients from low-income households.

Editorials Ⅲ follow-up studies Ⅲ mortality Ⅲ Fontan procedure

    The Fontan cross - sectional study : testing for correlations among health - related quality of life , maximal exercise performance , and ventricular masstovolume ratio

    • Circulation
    • 2004