The Fontan circulation: What have we learned? What to expect?

Area of Science:

• Cardiology
• Pediatric Cardiac Surgery
• Congenital Heart Disease

Background:

• The Fontan operation is a palliative surgical procedure for patients with complex congenital heart defects leading to a functionally single ventricle.
• These patients experience ongoing attrition and have a reduced life expectancy compared to individuals with a normal biventricular circulation.

Purpose of the Study:

• To propose a rational approach for the future management of patients who have undergone the Fontan operation.
• To emphasize the need for a deeper understanding of Fontan attrition and improved outcome prediction.

Main Methods:

• This article presents an essay discussing the current knowledge and future directions in Fontan patient management.
• It reviews the concept of Fontan attrition and its implications for long-term survival.

Main Results:

• The Fontan operation, while life-extending, is palliative and associated with long-term complications and attrition.
• Current methods for predicting outcomes in Fontan patients may not be sufficiently refined.

Conclusions:

• A better understanding of Fontan attrition is crucial for improving patient selection and long-term care.
• Developing more sophisticated methods to predict outcomes can aid in preventing, delaying, or treating late complications, thereby enhancing the quality of life and longevity for these individuals.