Current Treatment Options for the Failing Fontan Circulation

Area of Science:

• Cardiology
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• The Fontan operation, introduced in 1968, is a palliative surgical procedure for complex congenital heart malformations.
• It is utilized when biventricular repair is not feasible, offering improved outcomes over earlier palliative methods.

Purpose of the Study:

• To review the common complications associated with Fontan circulation.
• To outline the current treatment strategies for these complications.

Main Methods:

• Literature review of studies on Fontan circulation complications and management.
• Synthesis of information on pathophysiology and clinical presentation of adverse events.

Main Results:

• Fontan circulation is associated with significant long-term complications.
• These include myocardial dysfunction, arrhythmias, hepatic dysfunction, protein-losing enteropathy, plastic bronchitis, and thromboembolism.

Conclusions:

• Despite its benefits, the Fontan procedure carries risks that impact long-term survival.
• Understanding and managing these complications is crucial for improving life expectancy in affected patients.