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Fontan Procedure

For those whose hearts only have one functioning ventricle at birth, a Fontan treatment is required. Following a Fontan treatment, your child's physiology routes all oxygen-poor blood directly to the pulmonary artery rather than passing through the heart chambers. After surgery, most patients survive for a further 30 years or longer. The last single-ventricle operation that ultimately directs a child's oxygen-poor blood passively to their pulmonary artery rather than via their heart is frequently a Fontan surgical surgery. Their pulmonary artery travels to their lungs, where oxygen is taken up by their blood.

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About Fontan Procedure

The Fontan procedure lets oxygen-poor blood from the lower part of your body go straight to your pulmonary artery (and then lungs) for oxygen instead of going through your heart first. This procedure usually follows a different operation (Glenn procedure) that sends oxygen-poor blood from your upper body to your pulmonary artery and lungs.

After the Fontan heart procedure, all oxygen-poor blood goes to and through your pulmonary artery to your lungs instead of going through your heart first. This blood flows in a passive way, or without a pumping ventricle to move it. 

Procedure of Fontan Procedure

A Fontan procedure can treat several heart conditions that involve a ventricle or valve issue, such as Hypoplastic left heart syndrome (the most common reason for a Fontan procedure), Hypoplastic right heart syndrome, Tricuspid atresia, Pulmonary atresia with intact ventricular septum, Severe Ebstein’s anomaly, Double inlet left ventricle and others. 

  • Preoperative Evaluation: An extensive assessment of the patient's anatomy, general health, and cardiac status is carried out before to the Fontan treatment. This includes using imaging techniques to evaluate the anatomy and function of the heart, such as cardiac catheterization, echocardiography, and MRI.
  • Anesthesia and Incision: The process is carried out while sedated broadly. To reach the heart and join the blood vessels involved in rerouting blood flow, a midline incision is made in the chest.
  • 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.
  • Rerouting Blood Flow: The superior vena cava (SVC) and the right atrium or pulmonary artery are connected (anastomosed) by the surgeon. This sends blood from the head and upper body that has lost oxygen straight to the lungs where it can be replenished.
  • Additional Modifications: Additional changes to maximize blood flow could include using conduits, valves, or patches to reroute blood through the pulmonary arteries and stop blood backflow, depending on the particular heart defect of the patient.
  • 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- After the Fontan operation, patients need to get ongoing cardiac care. Cardiologists should be consulted on a regular basis to monitor heart function, measure oxygen levels, and handle any complications or long-term problems. Prescription drugs may be used to support heart function, control irregular heart rhythms, and avoid blood clots.

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