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Evaluating the Longevity of the Fontan Pathway
John M Kelly1,2,3, Gabriel J M Mirhaidari4,5, Yu-Chun Chang4,5
1Center for Regenerative Medicine, Abigail Wexner Research Institute At Nationwide Children's Hospital, Columbus, OH, USA. john.kelly@nationwidechildrens.org.
Pediatric Cardiology
|November 8, 2020
Summary
Children undergoing Fontan palliation experience long-term complications. This review examines how graft materials impact Fontan pathway changes and patient outcomes, aiding better follow-up for single ventricle patients.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Surgical Innovation
Background:
- Single ventricle physiology presents significant challenges for pediatric patients.
- Fontan palliation is a complex procedure with diverse long-term complications.
- Variability in surgical techniques and graft materials complicates patient evaluation.
Purpose of the Study:
- To review changes within the Fontan pathway related to graft materials.
- To establish the relationship between graft material, pathway changes, and patient outcomes.
- To provide a comprehensive overview for evaluating single ventricle patients.
Main Methods:
- Historical review of the Fontan procedure's evolution.
- Analysis of design changes and biomaterial incorporation.
- Delineation of Fontan pathway changes: stenosis, differential growth, thrombosis, calcification.
Main Results:
- Graft material significantly influences the development of Fontan pathway complications.
- Specific pathway changes correlate with altered hemodynamics and functional capacity.
- Understanding these changes is crucial for managing Fontan-associated comorbidities.
Conclusions:
- Graft material is a critical factor in Fontan pathway integrity and patient prognosis.
- Standardized diagnostic modalities are needed for consistent patient follow-up.
- Assessing pathway changes relative to hemodynamics and comorbidities improves patient care.
