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Related Experiment Videos

The Fontan procedure in adults.

G R Veldtman1, A Nishimoto, S Siu

  • 1University of Toronto Congenital Cardiac Centre for Adults, Stroke Ronald Lewar Centre of Excellence, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada.

Heart (British Cardiac Society)
|August 22, 2001
PubMed
Summary

The Fontan operation in adults shows acceptable survival rates and improved functional class. However, late complications like ventricular dysfunction and arrhythmias occur, though less frequently than in non-Fontan patients.

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Area of Science:

  • Adult congenital heart disease
  • Cardiac surgery outcomes
  • Single ventricle physiology

Background:

  • The Fontan operation is a palliative procedure for single ventricle physiology.
  • Long-term outcomes in adults undergoing Fontan operations require further investigation.
  • Comparison with non-Fontan palliation strategies is essential for understanding optimal management.

Purpose of the Study:

  • To evaluate the 20-year experience with adult Fontan operations.
  • To compare late outcomes of adult Fontan survivors with a cohort of non-Fontan single ventricle patients.

Main Methods:

  • Retrospective analysis of adult patients (>18 years) who underwent Fontan operation between 1982-1998.
  • Comparison with a cohort of 50 adults with single ventricle who did not have a Fontan operation.

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  • Data collection on mortality, functional class (NYHA), ventricular function, and arrhythmias.

    • Main Results:

    • 61 adult Fontan patients with a median follow-up of 10 years had 15-year actuarial survival of 67%.
    • Fontan patients showed improved New York Heart Association functional class (80% vs 58%) but developed late ventricular dysfunction (34%) and arrhythmias (57%).
    • Fontan survivors demonstrated better functional class and fewer arrhythmias compared to the non-Fontan group.

    Conclusions:

    • The Fontan operation in adults offers acceptable early and late survival.
    • Late post-operative complications, including ventricular dysfunction and arrhythmias, occur but are less severe than in non-Fontan single ventricle adults.