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Fontan procedure--indication and clinical results.

E R de Vivie, W Ruschewski, G Köveker

    The Thoracic and Cardiovascular Surgeon
    |December 1, 1981
    PubMed
    Summary

    The Fontan procedure, a surgical treatment for complex heart conditions like tricuspid atresia and single ventricle, showed improved outcomes with modifications. Early mortality decreased after 1977, with most patients demonstrating excellent results post-surgery.

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    Area of Science:

    • Cardiology
    • Pediatric Cardiac Surgery
    • Congenital Heart Disease

    Background:

    • Tricuspid atresia, univentricular heart, and single ventricle are severe congenital heart defects.
    • The Fontan procedure is a palliative surgical option for these conditions.
    • Early Fontan procedures had significant mortality and morbidity.

    Purpose of the Study:

    • To evaluate the outcomes of the Fontan or modified Fontan procedure.
    • To assess the impact of modifications on early and late mortality.
    • To analyze postoperative physiological parameters and patient results.

    Main Methods:

    • Retrospective analysis of 27 Fontan/modified Fontan procedures performed between 1975-1981.
    • Inclusion of patients with tricuspid atresia, univentricular heart, and single ventricle.

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  • Review of pre-operative palliative surgeries, procedural modifications, and post-operative data.

    • Main Results:

    • Overall early mortality was 22% (6/27), with 3 deaths in the initial period (1975-1977) and 3 in the later period (1978-1981).
    • Postoperative cardiac catheterization in 17 patients showed excellent results in 13 (76%).
    • Diminished arterial oxygen saturation was noted in 4 patients, 3 of whom had prior Glenn palliation.

    Conclusions:

    • Modifications to the Fontan procedure, introduced in 1977, appeared to improve early survival rates.
    • The modified Fontan procedure demonstrated favorable long-term outcomes in a majority of patients.
    • Careful patient selection and surgical technique are crucial for successful Fontan palliation.