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A prelude to Fontan

F Robicsek1, L T Watts

  • 1Department of Thoracic and Cardiovascular Surgery, Carolinas Heart Institute, Carolinas Medical Center and Heineman Medical Research Laboratories, 1001 Blythe Blvd., Suite 300, Charlotte, NC 28203, USA. Francis.Robicsek@carolinashealthcare.org

Pediatric Cardiology
|September 5, 2007
PubMed

Insights

Decades of research focused on bypassing the right heart before the Fontan operation. Successful animal experiments and partial clinical bypass paved the way for this crucial surgical innovation.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Medical History

Background:

  • Intensive research preceded the Fontan operation, aiming to bypass the right heart.
  • Experimental and clinical efforts focused on achieving right heart bypass.
  • This historical context is crucial for understanding the development of the Fontan procedure.

Observation:

  • Right heart bypass was successfully achieved in animal models.
  • Clinical application of right heart bypass was limited to partial bypass techniques.
  • Superior cava-right pulmonary artery anastomosis was a key partial bypass method.

Findings:

  • Experimental success in right heart bypass did not fully translate to clinical practice.
  • Partial bypass, specifically superior cava-right pulmonary artery anastomosis, saw clinical success.
  • These prior efforts established the foundation for the Fontan operation.

Implications:

  • Understanding historical attempts at right heart bypass is essential for appreciating the Fontan operation's development.
  • The limitations encountered in clinical bypass informed the eventual design of the Fontan procedure.
  • This background highlights the iterative nature of surgical innovation in congenital heart disease.

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