Four decades of Fontan palliation.
The Fontan palliation was introduced in 1968 to treat cardiac malformations unsuitable for biventricular repair. This procedure has transformed the surgical management of congenital heart disease. In this Review, we reflect on the outcomes and clinical problems associated with this unique circulation after more than 40 years of experience. We also summarize the evolution of the Fontan procedure, highlight the long-term clinical issues and their management, and consider future expectations of a circulation driven by a single ventricle with the systemic and pulmonary blood flow in series rather than in parallel.
de Leval
Marc R
MR
Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, UK.
Deanfield
John E
JE
D001145:Arrhythmias, Cardiac; D017079:Exercise Tolerance; D018729:Fontan Procedure / Q000266:history / Q000379:methods*; D018610:Heart Bypass, Right; D006330:Heart Defects, Congenital / Q000266:history / Q000601:surgery*; D006333:Heart Failure; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008107:Liver Diseases; D011652:Pulmonary Circulation; D016896:Treatment Outcome