title: Fontan conversion with hepatic vein exclusion: a means for hepatic preservation in single ventricle heart disease.
abstract: Patients with single ventricle heart disease often undergo staged surgical palliation, ultimately resulting in Fontan anatomy and physiology. Long-term consequences include cirrhosis of the liver, protein-losing enteropathy, and premature death. Elevated central venous pressure and venous congestion transmitted to the abdominal viscera have been implicated in the aetiology of many of these complications. We present a novel operation directed at protecting the liver and intestines by excluding the splanchnic venous return from the Fontan pathway. Instead of exposure to elevated Fontan pressures, the liver and intestines will be exposed to lower common atrial pressures. We hope that this modification will minimise the abdominal complications of Fontan anatomy and physiology.
authors.affiliation: 1Department of Cardiothoracic Surgery,Emory University,Atlanta,Georgia,United States of America.
authors.forename: Brian
authors.initials: B
authors.lastname: Kogon
authors.affiliation: 2Sibley Heart Center Cardiology,Children's Healthcare of Atlanta,Atlanta,Georgia,United States of America.
authors.forename: Michael
authors.initials: M
authors.lastname: McConnell
authors.affiliation: 3Department of Cardiology,Emory University,Atlanta,Georgia,United States of America.
authors.forename: Wendy
authors.initials: W
authors.lastname: Book
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects*; D006352:Heart Ventricles / Q000002:abnormalities*; D006439:Hemodynamics; D006503:Hepatic Veins; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D011183:Postoperative Complications / Q000209:etiology*; D011504:Protein-Losing Enteropathies / Q000209:etiology; D014057:Tomography, X-Ray Computed; D018785:Tricuspid Atresia / Q000601:surgery*; D014463:Ultrasonography
keywords: Fontan conversion; Single ventricle; hepatic vein exclusion