To evaluate the efficacy of chest roentgenograms and echocardiograms in identifying pulmonary venous pathway obstruction in patients after the modified Fontan procedure, the records of 297 patients who underwent 307 Fontan procedures between 1984 and 1990 were reviewed. Twelve cases of pulmonary venous pathway obstruction documented by autopsy (3 cases) or cardiac catheterization (9 cases with ...

BACKGROUND The Fontan procedure has been modified several times since it was introduced into practice in 1968. As many patients now survive to adulthood, attention is directed towards their clinical status and late morbidity. We report our surgical experience of 30 years in Fontan procedures. METHODS From January 1985 to January 2015, 80 patients underwent Fontan surgery. Twenty-one patients ...

INTRODUCTION The Fontan operation (modified from its original version) affords excellent palliation for many patients with various forms of anatomic or functional single ventricle. The purpose of this study was to evaluate the outcome of our experience with the Fontan procedure in Greece. METHODS Fifty-eight consecutive patients with single ventricle physiology had a modified Fontan operation...

OBJECTIVES To identify factors associated with hospital and long-term outcomes in a binational cohort of extracardiac conduit (ECC) Fontan recipients. METHODS All patients who underwent an ECC Fontan procedure from 1997 to 2010 in Australia and New Zealand were identified, and perioperative, follow-up, echocardiographic and reintervention data collected. Risk factors for early and late mortal...

OBJECTIVE To assess the use of detachable coils as an alternative method to occlude interatrial communications after Fontan operations. DESIGN Descriptive clinical study of selected patients after Fontan operation with interatrial communications inappropriate for transcatheter umbrella occlusion. SETTING Tertiary paediatric cardiac referral centre. PATIENTS Seven patients after Fontan ope...

Parallel advancements in surgical technique, preoperative and postoperative care, as well as a better understanding of physiology in patients with duct-dependent pulmonary or systemic circulation and a functional single ventricle, have led to superb results in staged palliation of most complex congenital heart disease (CHD) [1]. The Fontan procedure and its technical modifications have resulted...

1. Jayakumar KA, Addonizio LJ, Kichuk-Chrisant MR, et al. Cardiac transplantation after the Fontan or Glenn procedure. J Am Coll Cardiol 2004;44:2065–72. 2. Boucek MM, Edwards LB, Keck BK, et al. Registry for the International Society for Heart and Lung Transplantation: Seventh Official Pediatric Report—2004. J Heart Lung Transplant 2004;23:933–47. 3. Bernstein D, Naftel D, Chin C, et al. Pedia...

The Fontan operation is performed as a palliative procedure to improve survival in infants born with a functionally univentricular circulation. The success of the operation is demonstrated by a growing adult Fontan population that exists with this unique physiology. Late follow-up has demonstrated expected and unexpected sequelae, and has shown multisystem effects of this circulation. This revi...

Background Staged palliation culminating with the Fontan procedure has dramatically increased survival in children with single ventricle anatomy. However, long-term morbidity and mortality continue to be significant. This has been linked to ventricular myocardial fibrosis and scarring and subsequent altered contractile mechanics with abnormal regional wall motion and strain, but has not been fu...

BACKGROUND The Fontan circulation, a result of a palliative procedure in patients with single systemic ventricles, is defined by chronically elevated pulmonary vascular resistance. When traditional heart failure therapies fail, pharmacological agents that reduce pulmonary artery pressures may be used. These include endothelial-receptor antagonists, prostanoids and phosphodiesterase type 5 inhib...