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Updated: Jul 25, 2026
09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Factors associated with stroke following the Fontan procedure
Pediatric Cardiology
|November 1, 1995
Summary
Late neurologic complications, including strokes, occurred in 8.8% of patients after the Fontan procedure, potentially linked to residual shunts. Further research is needed to understand brain injury risks.
Area of Science:
- Cardiology
- Neurology
- Pediatric Surgery
Background:
- The Fontan procedure is a palliative surgery for complex congenital heart defects.
- Long-term complications, particularly neurologic issues, require further investigation.
- High-altitude living may influence outcomes.
Purpose of the Study:
- To determine the frequency of late central neurologic complications after the Fontan procedure.
- To assess the association between neurologic events and residual shunts.
- To evaluate potential risk factors for stroke in this population.
Main Methods:
- Retrospective review of 68 consecutive Fontan procedures performed between 1978 and 1993.
- Analysis of neurologic symptoms, magnetic resonance imaging (MRI) findings, and relevant clinical data.
- Assessment of patients residing at a mean altitude of 4500 feet.
Main Results:
- 8.8% of surviving patients experienced strokes with MRI-defined brain injury.
- Two patients had transient neurologic symptoms without MRI evidence of brain injury.
- All stroke patients and one with transient symptoms had residual right-to-left shunts.
Conclusions:
- Strokes are a significant complication following the Fontan procedure.
- Residual right-to-left shunts may contribute to thromboembolic events and brain injury.
- The role of shunts in asymptomatic patients requires further study.
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