A new modification of the Fontan operation for complex cardiac anomalies is described. The technique comprises superior vena cava-pulmonary artery anastomosis and inferior vena cava-pulmonary artery bridging via a composite conduit connected to the inferior vena cava via the right atrium, totally excluding the right heart. The procedure was applied to a patient with complex cardiac abnormalitie...

Effective surgical palliation for complex congenital heart disease in infancy and childhood allows these patients to live into adulthood but may be associated with adverse outcomes over the longer term. Management of adult patients with “Fontan physiology” is especially challenging. The Fontan operation was first described in 1971 so that the oldest surviving patients with this procedure are on...

OBJECTIVES The purpose of this study was to compare the clinical and echocardiographic features of adults who developed atrial tachyarrhythmias (ATs) late after a Fontan procedure with those who have remained free of arrhythmias. BACKGROUND Atrial tachyarrhythmias are a frequent complication of the Fontan operation. However, the outcomes in adult patients with AT who have had the Fontan opera...

background: fenestration in the modified fontan operation allows right-to-left shunting, which reduces the fontan pathway pressure and improves cardiac output. however, on account of the fact that persistent right-to-left shunting results in cyanosis and paradoxical emboli, fenestration closure is recommended after recovery from the fontan operation. methods: this study recruited 3 patients who...

OBJECTIVE The Fontan operation has been proposed as definitive palliation for an increasing variety of hearts with complex univentricular anatomy, but late morbidity after Fontan operation is still a matter of concern. This retrospective study evaluates the late outcome in patients with Fontan circulation. METHODS We included 121 consecutive patients that underwent Fontan operation between 19...

This paper describes supraventricular cardiac arrhythmias and sick sinus syndrome in patients with univentricular heart defects, following Fontan procedure. The Fontan operation is a well established surgical procedure in which the right atrium is connected with the pulmonary artery. This technique relieves the functional problems resulting from having a univentricular heart and it is also asso...

OBJECTIVE To determine outcomes of patients undergoing a bidirectional cavo-pulmonary shunt (BCPS) in the Fontan era. METHODS From 1990 to 2000, 212 patients underwent a BCPS in a single institution at a mean age of 2.6+/-5 years. RESULTS Hospital mortality was 6% (13 patients). Five patients were lost to follow-up (3%). After a mean of 9+/-4 years, 15 patients had not yet been referred for...

Atrial arrhythmias have for decades been recognized as a principal late complication of the Fontan procedure. A specific connection between the 2 was recognized soon after the procedure emerged as a standard clinical pathway for patients with single ventricle physiology. Intra-atrial reentrant tachycardia (IART) is a major cause of morbidity in the form of recurring symptoms and need for medica...