The Fontan circulation: a challenge to William Harvey?
The Fontan operation, which places the systemic and pulmonary circulations in series and is driven by a single ventricular chamber, is the treatment of choice for patients born with one ventricle. Its introduction 35 years ago was the result of a flurry of experimental and clinical research that had started in the 1940s. A large number of children have benefited and continue to benefit from the Fontan operation, but there is a genuine concern that, despite the refinement of the surgical procedures in the past 20 years, continuing attrition might be inevitable. This adverse effect can lead to a decline in functional capacity, and premature late death.
de Leval
Marc R
MR
Great Ormond Street Hospital for Children NHS Trust, London, UK. DeLevM@gosh.nhs.uk
D003097:Collateral Circulation; D003326:Coronary Circulation; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities*; D006801:Humans; D011379:Prognosis