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The fontan connections: past, present, and future
Sameh M Said1, Harold M Burkhart, Joseph A Dearani
1Division of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA.
Insights
The Fontan procedure is a vital surgery for single ventricle patients, separating circulations to improve oxygenation. This review details its evolution since 1971.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Single ventricle physiology involves parallel systemic and pulmonary circulations.
- Patients rely on one functional ventricular chamber.
- The Fontan procedure aims to create separate circulations.
Purpose of the Study:
- To review the Fontan procedure and its historical modifications.
- To discuss refinements in surgical techniques since 1971.
- To provide an overview of this critical intervention for single ventricle palliation.
Main Methods:
- Literature review of the Fontan procedure.
- Analysis of surgical modifications and refinements.
- Historical overview of clinical practice since 1971.
Main Results:
- The Fontan procedure has evolved significantly since its inception.
- Various modifications have improved outcomes for single ventricle patients.
- The goal remains to optimize palliation and tissue oxygenation.
Conclusions:
- The Fontan procedure is a cornerstone in managing single ventricle defects.
- Continuous refinement has enhanced its efficacy.
- It represents a crucial step in achieving adequate tissue oxygenation.
Abstract:
The Fontan procedure is now considered the final common pathway for patients with anatomical or functional single ventricle. These patients initially have their systemic and pulmonary circulations in parallel, supported by one functional ventricular chamber. The ultimate goal with this procedure is to separate the two circulations, to prevent mixing of venous and arterial blood, and to provide adequate tissue oxygenation. The objective of this article is to review the Fontan procedure with its various modifications and refinements since its introduction to clinical practice in 1971, by Fontan and Baudet.
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