Late deaths after Fontan procedure: the next frontier.

Abstract:

PURPOSE OF REVIEW:It has been more than 4 decades since the development of Fontan operation. With the contemporary surgical strategies to treat the patients with a single ventricle physiology, the medium-term survival of the patients following Fontan operation is excellent. Nonetheless, the Fontan circulation with a pumpless pulmonary circulation has fundamental physiologic limitations, which are associated with late Fontan failure and deaths. There has been an exponential growth of adolescence and adults living with a Fontan circulation, which poses significant challenges in future. RECENT FINDINGS:In this review, we discuss challenges and potential opportunities to treat the failing Fontan circulation. The specific topics include medical therapy, imaging, and therapeutic interventions for lymphatic abnormalities, transplantation, and mechanical support. The article also summarizes quality of life among the patients with the Fontan circulation. SUMMARY:Surgical techniques, developing novel diagnostic and therapeutic tools, and increasing our understanding of the failing Fontan physiology is essential to improve the overall long-term outcome of this entity.

journal_name

Curr Opin Cardiol

authors

Luo S,Honjo O

doi

10.1097/HCO.0000000000000603

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

156-163

issue

2

eissn

0268-4705

issn

1531-7080

journal_volume

34

pub_type

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