Fontan Operation: Indications, Short and Long Term Outcomes

Area of Science:

• Pediatric Cardiology
• Congenital Heart Disease Surgery
• Cardiovascular Physiology

Background:

• The Fontan operation is a palliative surgical procedure for patients with single-ventricle physiology.
• Historically, the Fontan procedure has evolved significantly since its inception.
• Current approaches involve staged palliation, bidirectional Glenn, and total cavo-pulmonary connection with fenestration.

Purpose of the Study:

• To describe the evolution and current state of the Fontan operation.
• To highlight the benefits of staged total cavo-pulmonary connection with fenestration.
• To emphasize the importance of managing post-operative complications.

Main Methods:

• Review of the historical modifications of the Fontan operation.
• Description of the current staged approach (Stage I, II, and III).
• Identification of patient candidacy for the Fontan surgery.

Main Results:

• Staged total cavo-pulmonary connection with fenestration has significantly improved morbidity and mortality rates.
• The modified Fontan operation is indicated for patients with a single functioning ventricle.
• Complications, although diminished, still occur and require prompt management.

Conclusions:

• The modern Fontan operation represents a significant advancement in treating single-ventricle congenital heart defects.
• Continuous monitoring and timely intervention are crucial for optimizing long-term outcomes.
• Further research may focus on refining techniques to further minimize long-term complications.