Fontan procedure

Fontan procedure is a type of heart surgery that is performed to treat certain congenital heart defects. This procedure is typically performed on children, and it involves redirecting the flow of blood from the vena cava (the large vein that carries de-oxygenated blood from the body back to the heart) directly to the pulmonary arteries, bypassing the right ventricle.

History

The Fontan procedure was first described in 1971 by Francis Fontan and Eugenio Baudet. The procedure has undergone several modifications since its inception, with the goal of improving outcomes and reducing complications.

Indications

The Fontan procedure is indicated for children with certain types of congenital heart defects where only one ventricle is functional. These conditions include tricuspid atresia, double inlet left ventricle, and hypoplastic left heart syndrome.

Procedure

The Fontan procedure is performed under general anesthesia. The surgeon makes an incision in the chest to access the heart. The blood flow is then redirected from the vena cava to the pulmonary arteries, bypassing the right ventricle. This is achieved by creating a tunnel or conduit within the heart, or by connecting the vena cava directly to the pulmonary arteries.

Risks and Complications

As with any major surgery, the Fontan procedure carries risks. These include bleeding, infection, arrhythmias, and heart failure. Long-term complications can include protein-losing enteropathy, liver disease, and thromboembolism.

Outcomes

The Fontan procedure has significantly improved the survival and quality of life for children with single-ventricle heart defects. However, long-term follow-up is necessary, and some patients may require additional surgeries or interventions in the future.

See Also

• Congenital heart defect
• Heart surgery
• Pulmonary arteries
• Vena cava

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  Diagram of the Fontan procedure
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  CT scan showing Glenn shunt and Fontan in tricuspid atresia
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  Photo of Dr. Fontan and Dr. Kreutzer