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Pediatric cardiac surgery.

J M Quaegebeur1

  • 1College of Physicians and Surgeons of Columbia University, New York.

Current Opinion in Cardiology
|January 1, 1993
PubMed
Summary

The Fontan procedure offers palliative care for complex congenital heart defects when biventricular repair is not possible. However, evidence suggests its palliative nature does not support expanding its use in pediatric cardiac surgery.

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Area of Science:

  • Pediatric Cardiac Surgery
  • Congenital Heart Disease
  • Palliative Care

Background:

  • The Fontan procedure is increasingly used for complex congenital heart lesions due to a lack of alternative biventricular repair options.
  • Despite its expanding role, the Fontan procedure is recognized as a palliative measure, not a definitive cure.

Purpose of the Study:

  • To address the controversy surrounding the expanding indications for the Fontan procedure.
  • To review the current status of treating hypoplastic left heart syndrome, transposition of the great arteries, and tetralogy of Fallot.

Main Methods:

  • Review of medium- and long-term results of the Fontan operation.
  • Analysis of treatment strategies for specific complex congenital heart defects.

Main Results:

  • Medium- and long-term outcomes confirm the palliative nature of the Fontan procedure.
  • Current evidence does not support broadening the indications for the Fontan procedure.

Conclusions:

  • The Fontan procedure remains a palliative option for specific complex congenital heart conditions.
  • Careful consideration and evidence-based criteria are essential when determining the indications for the Fontan procedure in pediatric cardiac surgery.

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