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Related Experiment Videos

Experience with the Fontan procedure.

H Laks, J C Milliken, J K Perloff

    The Journal of Thoracic and Cardiovascular Surgery
    |December 1, 1984
    PubMed
    Summary
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    Modifications to the Fontan procedure offer excellent outcomes for complex congenital heart disease patients. This study highlights the procedure

    Area of Science:

    • Cardiology
    • Pediatric Cardiology
    • Cardiac Surgery

    Background:

    • Complex congenital heart disease necessitates advanced surgical interventions.
    • The Fontan procedure is a palliative surgical option for single-ventricle physiology.
    • Modifications aim to improve outcomes and reduce complications.

    Purpose of the Study:

    • To evaluate the outcomes of modified Fontan procedures in patients with complex congenital heart disease.
    • To assess the efficacy of different surgical techniques and the impact of venous assist devices.
    • To analyze long-term functional status and survival rates.

    Main Methods:

    • Retrospective analysis of 45 patients undergoing modified Fontan procedures between 1975 and present.
    • Review of primary diagnoses including tricuspid atresia, univentricular heart, and pulmonary atresia.

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  • Assessment of surgical connections (atrial-pulmonary vs. atrial-ventricular), use of conduits, and postoperative interventions like venous assist devices.

    • Main Results:

    • Overall mortality was 12% (3 early, 2 late deaths), predominantly in univentricular heart patients.
    • Venous assist devices were effective in improving postoperative cardiac output.
    • Long-term follow-up showed 78% of patients in New York Heart Association Class I, indicating good functional status.

    Conclusions:

    • Modified Fontan procedures are effective for carefully selected patients with complex congenital heart disease.
    • While challenges like venous hypertension exist, outcomes are generally favorable.
    • The procedure remains a valuable option for improving the quality of life in these patients.