title: Pulmonary Artery Reconstruction with Donor Aortic Homograft During Cardiac Transplantation in the Failed Fontan Circulation.
abstract: The advanced surgical management of patients with single ventricle physiology, in particular the hypoplastic left heart syndrome, has resulted in an increased number of patients with a Fontan circulation. In a proportion of these patients, the Fontan circulation will ultimately fail and cardiac transplantation may be required. Their course may be complicated by the hemodynamic consequences of the failing Fontan, multiple previous operations, and the frequent need for complex reconstruction at transplantation. We describe a patient with a failed modified Fontan circulation requiring concomitant pulmonary artery reconstruction and cardiac transplantation and review potential reconstruction techniques.
authors.affiliation: Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Australia.
authors.forename: Johann
authors.initials: J
authors.lastname: Brink
authors.affiliation: Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Australia.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Saxena
authors.affiliation: Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Australia.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Yong
authors.affiliation: Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Australia.
authors.forename: David
authors.initials: D
authors.lastname: McGiffin
mesh_terms: D000015:Abnormalities, Multiple; D064591:Allografts; D001011:Aorta / Q000637:transplantation*; D005260:Female; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000601:surgery*; D006333:Heart Failure / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D016027:Heart Transplantation / Q000379:methods*; D006352:Heart Ventricles / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D008103:Liver Cirrhosis; D008875:Middle Aged; D011651:Pulmonary Artery / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012720:Severity of Illness Index; D017211:Treatment Failure; D016896:Treatment Outcome; D018785:Tricuspid Atresia / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*