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Outcomes after the Fontan procedure.

Bradley S Marino1

  • 1Department of Pediatrics, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, 19104, USA. marino@email.chop.edu

Current Opinion in Pediatrics
|September 28, 2002
PubMed
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Advances in pediatric cardiology and surgery have improved survival for infants with single-ventricle heart defects undergoing the Fontan procedure. However, significant long-term health issues persist despite surgical innovations.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Intensive Care Medicine

Background:

  • Significant advancements in pediatric cardiac care have improved survival rates for infants with critical congenital heart disease.
  • The single-ventricle population has particularly benefited from staged palliation, including the Fontan procedure, leading to increased survival.
  • Recent studies highlight progressive improvements in outcomes following the Fontan procedure due to surgical and technological innovations.

Purpose of the Study:

  • To review recent outcomes and persistent morbidities in single-ventricle patients after Fontan completion.
  • To assess the impact of surgical innovations and technological advancements on Fontan procedure outcomes.

Main Methods:

  • Review of recent studies focusing on outcomes after the Fontan procedure.

Related Experiment Videos

  • Analysis of surgical innovations (lateral tunnel, extracardiac modifications, fenestration) and technological improvements (modified ultrafiltration).

    • Main Results:

    • Improved early postoperative survival and intermediate/late outcomes reported in recent studies.
    • Surgical and technological advancements have contributed to better results after Fontan completion.
    • Despite improvements, significant morbidities remain, impacting long-term patient health.

    Conclusions:

    • While the Fontan procedure has seen survival improvements, persistent morbidities necessitate ongoing research and management strategies.
    • Key long-term complications include cardiac dysfunction, hemodynamic abnormalities, reduced exercise capacity, arrhythmias, protein-losing enteropathy, growth issues, and cognitive deficits.