Experiences with the Fontan operation.
Up to December 1980 we performed 21 Fontan operations: 8 for tricuspid atresia and 13 for a functional monoventricle. Although palliative, the operation is currently a good method of treating tricuspid atresia. In our experience, the use of a sufficiently large atriopulmonary valved conduit assures a more satisfactory immediate postoperative hemodynamic result than the atriobulbar non-valved connection (RA-infund. tunnel). Good results can be obtained by a modified Fontan operation in patients with a monoventricle. However, with this malformation, very careful preoperative selection of patients is necessary with special regard to pulmonary vascular resistance. The connection between the right atrium and pulmonary artery was established by a valved conduit in 15 patients; no valve was incorporated in the other 6 patients. The largest prostheses gave the best immediate postoperative hemodynamic results. Two patients with monoventricle were successfully reoperated for persistent right-left shunt. The 13 patients so far followed up for at least a year show definite improvement as compared with their preoperative condition. Late complications from the valved prostheses have not been observed so far.
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006330:Heart Defects, Congenital / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008722:Methods; D011651:Pulmonary Artery / Q000601:surgery; D014261:Tricuspid Valve / Q000002:abnormalities* / Q000601:surgery