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[Re-do Fontan operation--a case report]

R Toda¹, T Yuda, M Kaieda

¹Department of Cardiovascular Surgery, Prefectural Miyazaki Hospital, Japan.

[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai

|July 1, 1996

Summary

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A heart failure patient with a history of Fontan operation required valve replacement. Careful sternotomy is crucial during redo Fontan procedures to protect the conduit, and anticoagulation is recommended post-surgery.

Area of Science:

Cardiology
Congenital Heart Disease
Cardiac Surgery

Background:

A 32-year-old female presented with heart failure 26 years after Glenn and 7 years after a Fontan operation for tricuspid atresia type 1b.
The patient had a Björk-Shiley prosthetic valve (21 mm) implanted during the initial Fontan procedure.

Observation:

The patient underwent extirpation of a malfunctioning prosthetic valve.
Postoperative arteriography revealed no evidence of graft stenosis or abnormal pressure gradients between the right atrium and pulmonary artery.

Findings:

Redo Fontan operation involved sternotomy and prosthetic valve extirpation.
The prosthetic valve was deemed unnecessary in the redo Fontan procedure.

Implications:

Related Experiment Videos

Sternotomy during redo Fontan operations requires meticulous technique to avoid damage to the existing valved conduit.
Anticoagulation therapy is advised following redo Fontan surgery, even when prosthetic valves are removed.