Long-term issues after the Fontan procedure

Area of Science:

• Cardiology
• Pediatric Cardiac Surgery
• Adult Congenital Heart Disease

Background:

• The Fontan procedure corrects complex congenital heart defects, enabling survival into adulthood.
• Fontan circulation physiology presents unique long-term health challenges for adult survivors.
• Understanding these challenges is crucial for lifelong patient management.

Purpose of the Study:

• To review the different types of Fontan procedures and their physiological consequences.
• To outline the sequelae of Fontan circulation, including single-ventricle physiology and systemic venous hypertension.
• To discuss nursing assessments, treatment strategies, and emerging solutions for Fontan patients.

Main Methods:

• Literature review of Fontan procedure types and associated physiological changes.
• Analysis of sequelae such as nonpulsatile pulmonary perfusion and intracardiac scarring.
• Synthesis of information on nursing care, medical management, and surgical options.

Main Results:

• Identified four types of Fontan procedures and their specific impacts.
• Detailed the chronic physiological alterations and their clinical manifestations.
• Summarized current and potential future management approaches.

Conclusions:

• Fontan survivors face progressive health issues requiring specialized, lifelong care.
• Early identification of complications and tailored interventions are key to managing Fontan physiology.
• Further research and innovative treatments are needed to improve long-term outcomes and quality of life.