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Related Experiment Videos

Rest and exercise hemodynamics after the Fontan procedure

G B Shachar, B P Fuhrman, Y Wang

    Circulation
    |June 1, 1982
    PubMed
    Summary

    The Fontan procedure can lead to abnormal cardiovascular responses during exercise, even in asymptomatic patients. Conduit obstruction may worsen these responses and may not be detected during rest.

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    Area of Science:

    • Pediatric Cardiology
    • Cardiovascular Surgery
    • Hemodynamics

    Background:

    • The Fontan procedure is a palliative surgery for complex congenital heart defects.
    • Assessing long-term functional outcomes after the Fontan procedure is crucial.

    Purpose of the Study:

    • To evaluate the hemodynamic response to exercise in patients who have undergone the Fontan procedure.
    • To identify potential factors contributing to exercise intolerance.

    Main Methods:

    • Hemodynamic assessment including cardiac index, stroke index, and mixed venous oxygen saturation during rest and exercise.
    • Measurement of conduit gradients and atrial pressures.
    • Comparison with a control group of healthy individuals.

    Main Results:

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    • Patients demonstrated reduced cardiac index and stroke index at rest and during exercise.
    • Mixed venous oxygen saturations were significantly lower compared to controls.
    • Exercise increased conduit gradients, indicating functional obstruction, which was not evident at rest.

    Conclusions:

    • Cardiovascular response to exercise is abnormal after the Fontan procedure, even in asymptomatic patients.
    • Functional conduit obstruction may contribute to exercise limitations and may be masked during resting conditions.