title: Fontan physiology revisited.
abstract: The Fontan operation places the systemic and pulmonary circulations in series, driven by a single ventricular chamber. It has become the treatment strategy of choice for palliating single-ventricle congenital heart disease. This anatomy engenders profound changes in physiology, affecting the cardiovascular and respiratory systems with direct implications for anesthetic and intensive care. The physical basis of these changes and their sequelae are reviewed.
authors.affiliation: From the Department of Pediatric Cardiac Anesthesia, Boston Children's Hospital, Boston, Massachusetts; and Department of Pediatric Cardiology, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Matthew
authors.initials: M
authors.lastname: Jolley
authors.forename: Steven D
authors.initials: SD
authors.lastname: Colan
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rhodes
authors.forename: James
authors.initials: J
authors.lastname: DiNardo
mesh_terms: D000222:Adaptation, Physiological; D000818:Animals; D016887:Cardiopulmonary Resuscitation; D003326:Coronary Circulation; D017079:Exercise Tolerance; D015199:Extracorporeal Membrane Oxygenation; D018729:Fontan Procedure / Q000009:adverse effects / Q000401:mortality; D006330:Heart Defects, Congenital / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D008168:Lung / Q000098:blood supply* / Q000503:physiopathology; D008955:Models, Cardiovascular; D009200:Myocardial Contraction; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D011652:Pulmonary Circulation; D012123:Pulmonary Ventilation; D012307:Risk Factors; D016896:Treatment Outcome; D016276:Ventricular Function