Fontan completion without surgery.

Area of Science:

• Pediatric Cardiology
• Congenital Heart Disease
• Interventional Cardiology

Background:

• The Fontan procedure is a palliative surgery for complex single-ventricle congenital heart defects.
• Optimizing Fontan circuit hemodynamics and minimizing long-term complications remain critical challenges.
• Current Fontan completion strategies often involve prolonged recovery and potential surgical risks.

Purpose of the Study:

• To describe a novel combined surgical and transcatheter approach for Fontan completion.
• To evaluate the feasibility and early outcomes of a nonoperative, transcatheter Fontan completion strategy.
• To discuss the rationale and techniques associated with this innovative management approach.

Main Methods:

• A hybrid approach combining initial surgical intervention with subsequent transcatheter completion was developed.
• Detailed surgical techniques for preparing the Fontan circuit were employed.
• Transcatheter techniques were utilized for the final completion of the Fontan pathway in a nonoperative setting.

Main Results:

• The study reports early experiences with this novel combined approach.
• The transcatheter completion facilitated a nonoperative closure of the Fontan circuit.
• This strategy aims to optimize flow dynamics and potentially reduce early complications.

Conclusions:

• A combined surgical/transcatheter approach offers a promising alternative for Fontan completion.
• Nonoperative, transcatheter Fontan completion may enhance recovery and improve hemodynamic efficiency.
• Further investigation into long-term outcomes and broader applicability is warranted.