Fontan procedure is primarily performed in individuals born with single-ventricle congenital heart defects, where only one functional pumping chamber (ventricle) is present in the heart. Examples of such defects include hypoplastic left heart syndrome, tricuspid atresia, and pulmonary atresia. The Fontan procedure is typically performed in stages, with the final goal being the redirection of blood flow for optimal circulation.

1. Preoperative Evaluation: Before the Fontan procedure, a thorough evaluation of the patient's heart condition, anatomy, and overall health is conducted. This includes imaging tests, such as echocardiography, cardiac catheterization, and MRI, to assess the heart's structure and function.

2. Anesthesia and Incision: The procedure is performed under general anesthesia. A midline incision is made in the chest to access the heart and connect the blood vessels involved in rerouting blood flow.

3. Atrial Septectomy: In some cases, a previous surgical procedure called atrial septectomy is performed to create an opening between the two atria (upper chambers of the heart). This allows venous blood from the body to flow directly to the lungs.

4. Rerouting Blood Flow: The surgeon creates a connection (anastomosis) between the superior vena cava (SVC) and the right pulmonary artery or the right atrium. This directs oxygen-depleted blood from the upper body and head directly to the lungs for oxygenation.

5. Additional Modifications: Depending on the individual's specific heart defect, additional modifications may be made to optimize blood flow, such as the use of conduits, valves, or patches to redirect blood through the pulmonary arteries and prevent blood backflow.

6. Closure and Recovery: After the necessary connections are made, the incision is closed, and the patient is transferred to the recovery area. The recovery process involves close monitoring of vital signs, pain management, and gradual resumption of activities under the guidance of healthcare professionals.

Postoperative Care and Follow-up

Following the Fontan procedure, individuals require lifelong cardiac care. Regular follow-up appointments with cardiologists are essential to monitor heart function, assess oxygen levels, and manage any complications or potential long-term issues. Medications may be prescribed to prevent blood clots, manage heart rhythm abnormalities, and support heart function.