The Fontan Circulation
نویسندگان
چکیده
The original Fontan procedure was first introduced in the 1970s. The concept behind this surgical technique was revolutionary. It has subsequently transformed the lives of children born with complex congenital heart disease which was once thought to be inoperable and resulted in early death. The procedure itself has had several modifications over the decades, with subsequent improvements in long-term outcomes for these patients. Fontan patients are now surviving well into adulthood and the majority are able to live wholesome fulfilling lives. There are, however, a small proportion who are faced with the negative long-term physiological effects of this unconventional circulation. Early detection and management of these patients is the key to their long-term survival.
منابع مشابه
Anesthetic considerations for the pregnant patient with Fontan circulation
Goals 1. Understand the physiologic consequences of Fontan circulation 2. Understand the long term complications of patients with Fontan circulation 3. Understand how the Fontan operation has evolved in an attempt to reduce long term complications. 4. Understand how the physiologic changes of pregnancy affect Fontan circulation. 5. Understand the predictors we can use to determine how a patient...
متن کاملManagement of the failing Fontan circulation
The ‘Fontan circulation’ has evolved to include a variety of surgical procedures designed to overcome the absence of two distinct ventricular chambers. w1ew3 Inherent to this circulation is chronic elevation of right atrial and vena caval pressure, and absence of a dedicated power source to serve the pulmonary circulation, making low pulmonary vascular resistance and optimal systemic ventricula...
متن کاملVentricular afterload and ventricular work in fontan circulation: comparison with normal two-ventricle circulation and single-ventricle circulation with blalock-taussig shunts.
BACKGROUND Recent studies have indicated that there are inherent limitations associated with Fontan physiology. However, there have been no quantitative analyses of the effects of right heart bypass on ventricular afterload, hydraulic power, and resultant overall hemodynamics. Methods and Results- During routine cardiac catheterization, aortic impedance and ventricular hydraulic power were dete...
متن کاملHemodynamic performance of the Fontan circulation compared with a normal biventricular circulation: a computational model study.
The physiological limitations of the Fontan circulation have been extensively addressed in the literature. Many studies emphasized the importance of pulmonary vascular resistance in determining cardiac output (CO) but gave little attention to other cardiovascular properties that may play considerable roles as well. The present study was aimed to systemically investigate the effects of various c...
متن کاملCardiac rest and reserve function in patients with Fontan circulation.
OBJECTIVES In the present study, we systematically tested cardiac rest and reserve function in patients with Fontan physiology to check for inherent limitations of this circulation. BACKGROUND Details of the mechanisms of cardiac performance that could account for adverse outcome after Fontan surgery are not well understood. METHODS The subjects were 17 Fontan patients with good functional ...
متن کاملWhere Is the “Optimal” Fontan Hemodynamics?
Fontan circulation is generally characterized by high central venous pressure, low cardiac output, and slightly low arterial oxygen saturation, and it is quite different from normal biventricular physiology. Therefore, when a patient with congenital heart disease is selected as a candidate for this type of circulation, the ultimate goals of therapy consist of 2 components. One is a smooth adjus...
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