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Fontan Failure in Adult Patients: From Physiology to Solutions

Egor A Karev1, Oksana F Stovpyuk1, Daria V Alekseeva1

  • 1Functional Diagnostics, Federal State Budgetary Institution "V.A. Almazov National Medical Research Center" of the Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation.

World Journal for Pediatric & Congenital Heart Surgery
|June 11, 2026
PubMed

Insights

Adults with congenital heart defects, especially Fontan palliation, require specialized care. This review focuses on managing Fontan circulation in adults, identifying heart failure predictors and complications.

Area of Science:

  • Cardiology
  • Adult Congenital Heart Disease
  • Pediatric Cardiology

Background:

  • The population of adults with congenital heart defects is increasing.
  • Many adults have undergone childhood surgery for conotruncal anomalies and septal defects.
  • Management of Fontan circulation in adults is gaining attention due to improved pediatric cardiac surgery outcomes.

Purpose of the Study:

  • To review the unique pathophysiology of Fontan circulation in adults.
  • To discuss clinical management challenges in adult Fontan patients.
  • To identify predictors of heart failure and potential complications.

Main Methods:

  • Literature review of adult congenital heart disease management.
  • Analysis of pathophysiology specific to Fontan circulation.
  • Identification of clinical issues and complications in adult Fontan survivors.

Main Results:

  • Fontan circulation presents unique pathophysiological challenges in adults.
  • Specific predictors for heart failure decompensation can be identified.
  • Adult Fontan patients are at risk for various potential complications.

Conclusions:

  • Adults with Fontan palliation require specialized, lifelong care.
  • Understanding Fontan pathophysiology is crucial for managing adult patients.
  • Early identification of risk factors can improve outcomes and prevent complications.

Keywords:
Fontan circulationadult congenital heart diseasecardiac transplantheart failurelymphatic complications

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