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Heart transplant after the Fontan operation

Joseph W Rossano1, Robert E Shaddy1

  • 1Department of Pediatrics, Perelman School of Medicine, The Cardiac Center, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.

Cardiology in the Young
|January 10, 2014
PubMed

Insights

The Fontan operation can lead to circulatory failure over time in patients with single ventricle hearts. Heart transplantation offers a potential solution for end-stage failure, with this review detailing its indications, evaluation, and outcomes.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Cardiac Surgery

Background:

  • The Fontan operation provides long-term palliation for functionally univentricular hearts.
  • Over time, patients undergoing the Fontan procedure may develop progressive circulatory failure.
  • End-stage failure necessitates consideration of advanced treatment options.

Purpose of the Study:

  • To review the indications for heart transplantation in Fontan patients.
  • To outline the evaluation process for heart transplantation in this cohort.
  • To discuss management strategies and outcomes following heart transplantation.

Main Methods:

  • Literature review of studies on heart transplantation in Fontan survivors.
  • Analysis of current guidelines and clinical practices.
  • Synthesis of data on pre- and post-transplant management and outcomes.

Main Results:

  • Heart transplantation is a viable option for select Fontan patients with end-stage failure.
  • Careful patient selection and management are crucial for successful outcomes.
  • Transplantation offers improved survival and quality of life for eligible individuals.

Conclusions:

  • Heart transplantation is an important consideration for Fontan patients experiencing circulatory failure.
  • Multidisciplinary evaluation and management optimize transplant outcomes.
  • Continued research is needed to further improve long-term results.

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