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Related Experiment Videos

Evolving anatomic and electrophysiologic considerations associated with Fontan conversion.

Constantine Mavroudis1, Carl Lewis Backer, Barbara J Deal

  • 1Division of Cardiovascular-Thoracic Surgery, The Children's Memorial Hospital, Northwestern University Medical School, Chicago, IL, USA. cmavroudis@childrensmemorial.org

Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
|April 17, 2007
PubMed
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Fontan conversion surgery restores cardiac anatomy and treats arrhythmias in single-ventricle patients. This complex procedure requires careful management of anatomical and electrophysiological challenges for successful outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Cardiac Electrophysiology

Background:

  • Fontan conversion surgery aims to correct anatomical abnormalities and treat atrial arrhythmias in patients with single-ventricle physiology.
  • Successful outcomes depend on understanding single-ventricle anatomy, Fontan connection configurations, right atrial dilatation, and associated congenital anomalies.

Purpose of the Study:

  • To present challenging anatomical and electrophysiological problems encountered during Fontan conversion and arrhythmia surgery.
  • To describe innovative solutions developed to address these complex cases.

Main Methods:

  • Review of challenging cases including takedown of Bjork-Fontan modification, management of right ventricular hypertension and tricuspid regurgitation, and atrial maze procedures.
  • Addressing hemodynamic issues like pulmonary vein stenosis, inferior vena cava retraction, and right atrial clots.

Related Experiment Videos

  • Utilizing modified maze procedures for diverse single-ventricle pathologies.

    • Main Results:

    • Fontan conversion with arrhythmia surgery performed on 109 patients since 1994.
    • Achieved a low mortality rate of 0.9%.

    Conclusions:

    • Fontan conversion with arrhythmia surgery is a successful procedure for complex single-ventricle patients.
    • Program success is attributed to strong collaboration between cardiothoracic surgery and cardiology teams.