The Fontan Procedure: Evolution in Technique; Attendant Imperfections and Transplantation for "Failure"

Ryan R Davies, Jonathan M. Chen, Ralph S. Mosca

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Application of the Fontan procedure has allowed the survival of many patients with univentricular cardiac lesions into mid adulthood. Despite its ingenious design, implementation, and thoughtful modifications, its attendant hemodynamic perturbations persist; central venous hypertension and reduced cardiac output. These aberrations in physiology have led to pernicious changes in organ function. A more thorough understanding of these derangements and attempts at Fontan revision have temporized, yet the morbidity and patient attrition persists. Mechanical assistance to normalize the circulation is being investigated and holds some promise. At present, cardiac transplantation remains the last stage of palliation for many.

Original languageEnglish (US)
Pages (from-to)55-66
Number of pages12
JournalSeminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual
Volume14
Issue number1
DOIs
StatePublished - Mar 30 2011

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Cardiology and Cardiovascular Medicine

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