BACKGROUND The Fontan circulation is critically dependent on elevated venous pressures to sustain effective venous return. We hypothesized that chronically increased systemic venous pressures lead to adaptive changes in regional and peripheral vessels to maintain cardiac output, especially when patients are upright. METHODS AND RESULTS Nine post-Fontan procedure patients (aged 13 to 24 years)...

OBJECTIVE To show possible alternative uses of the Rashkind ductal umbrella. DESIGN Descriptive study of selected, non-randomised patients; with specific congenital heart lesions other than an arterial duct. SETTING A tertiary referral centre. PATIENTS Nine patients with congenital heart lesions; four with interatrial communications after a fenestrated Fontan procedure two with large aort...

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 lon...

Introduction The management of supraventricular arrhythmias after the Fontan procedure with catheter ablation represents a significant challenge. This can be due to the access problems that are created by the currently used modification of the procedure, which uses an extracardiac conduit, as well as to the complex anatomic substrate that can be created by a combination of congenital and acquir...

Plastic bronchitis (PB), although a rare cause of airway obstruction, has mortality rates up to 50% in children after Fontan-type cardiac surgery. We present the case of an 18-month-old female patient with PB following pneumonia. At 6 months of age, the patient underwent the Glenn procedure due to functionally univentricular heart. Fiberoptic bronchoscopy revealed complete blockage of the left ...

Objective: The extracardiac Fontan procedure, as compared with classic atriopulmonary connections, may have the potential for optimizing ventricular and pulmonary vascular function by maximizing the laminar ̄ow principle, by the avoidance of intra-atrial suture lines and cardiac manipulation, and by minimizing cardiopulmonary bypass time. In this study the clinical results of this procedure are...