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903
Fontan Conversion: Literature Review and Lessons Learned Over 20 Years
Constantine Mavroudis1, Barbara J Deal2
1Johns Hopkins Children's Heart Surgery, Florida Hospital for Children, Johns Hopkins University School of Medicine, Orlando, FL, USA constantine.mavroudis.md@flhosp.org.
World Journal for Pediatric & Congenital Heart Surgery
|March 10, 2016
Summary
Fontan conversion offers improved outcomes for patients with Fontan circulation, addressing long-term complications like arrhythmias and venous obstructions. This review assesses 20 years of lessons learned from these interventions.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Adult Congenital Heart Disease
Background:
- Improved early survival after the Fontan operation necessitates lifelong management of single-ventricle physiology.
- Progressive pulmonary artery pressure is detrimental in Fontan circulation, unlike in biventricular physiology.
- Long-term Fontan patients face complications including pathway obstructions, valve dysfunction, and arrhythmias, impacting functional status.
Purpose of the Study:
- To review the literature on Fontan Conversion.
- To assess lessons learned over two decades of Fontan Conversion strategies.
Main Methods:
- Systematic review of existing literature on Fontan Conversion.
- Analysis of long-term outcomes and complications in Fontan patients.
Main Results:
- Identified common complications include venous pathway obstructions, pulmonary arteriovenous malformations, and atrial arrhythmias.
- Surgical and catheter interventions aim to mitigate morbidity and mortality associated with these complications.
- Older patients, particularly those with atriopulmonary connections, exhibit a higher burden of complications.
Conclusions:
- Fontan Conversion is a strategy to address progressive complications in Fontan circulation.
- Understanding long-term outcomes and lessons learned is crucial for optimizing patient management.
- Further research and intervention refinement are needed to improve functional status and longevity.
