The Fontan circulation: What have we learned? What to expect?
Our knowledge of the Fontan operation tends to indicate that it remains a palliative procedure for patients with a functionally single ventricle. There is a continuing attrition and the life expectancy of these patients is likely to be different from the life expectancy of a population of individuals having a biventricular circulation. This article is an essay on the rational approach for the future management of these patients. It is suggested that a better understanding of the continuing Fontan attrition and a more subtle way to predict outcomes of patients who do receive the Fontan could help in establishing better selection criteria and designing ways to prevent, delay, or treat the side-effects of this late attrition.
de Leval
M R
MR
Great Ormond Street Hospital for Children, London, UK.
D003097:Collateral Circulation; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D010166:Palliative Care; D011379:Prognosis; D011651:Pulmonary Artery / Q000601:surgery; D014684:Venae Cavae / Q000601:surgery