Sir, In their recent article (1987;57:543-7) on tricuspid atresia with transposition of the great arteries Warnes and Somerville emphasised the inportance of subaortic stenosis in these patients, especially those with coarctation. They suggested that the Fontan procedure was the procedure of choice in these patients but remarked that in patients with subaortic stenosis the prognosis after Fonta...

Methods Between 1986 and 2011, 179 children underwent heart transplantation for cardiomyopathy and end-stage congenital heart disease. Fifteen patients had single-ventricle physiology and underwent Fontan procedure. Five patients (mean age 6.6±1.2, range 2-14, years old) had failed Fontan circulation. Interval between Fontan procedure and failing circulation was 8-14 years. Indications for hear...

Background Single ventricle physiology (SVP) is one of the most severe forms of complex congenital heart disease (CHD). Patients undergo multiple surgical interventions including the Fontan procedure (caval venous return is routed directly to the pulmonary arteries). Despite the apparent success of the procedure, it is unclear why some patients develop ‘failing Fontan physiology’ while others r...

This paper describes supraventricular cardiac arrhythmias and sick sinus syndrome in patients with univentricular heart defects, following Fontan procedure. The Fontan operation is a well established surgical procedure in which the right atrium is connected with the pulmonary artery. This technique relieves the functional problems resulting from having a univentricular heart and it is also asso...

BACKGROUND A Fontan-type operation, i.e. a connection of the systemic veins and pulmonary arteries without subpulmonary ventricle, with different surgical techniques, is nowadays the only treatment option for patients with a functionally univentricular heart (UVH). Understanding the development of pulmonary arteries in patients who are considered for the Fontan procedure is important clinically...

OBJECTIVE The infant with a functional single ventricle (SV) and unobstructed pulmonary blood flow (UPBF) requires early protection of the pulmonary vascular bed to ensure suitability for a subsequent Fontan procedure. Systemic obstruction by aortic arch obstruction, subaortic stenosis, or combination of both, has been widely recognized as an important risk factor for poor outcome in children w...

OBJECTIVES The study was done to determine the prevalence of pulmonary emboli (PE) in asymptomatic adult Fontan patients and to identify the risk factors associated with PE. BACKGROUND Right atrial thrombi and systemic thromboembolic complications have been reported after the Fontan procedure. However, the frequency of silent PE in this patient population is not known. METHODS All consecuti...