Fontan operation

Last edited 08/2022 and last reviewed 09/2022

A Fontan operation is used to create a left to right shunt in congenital cardiac disease.

• the right atrium is anastomosed to the pulmonary artery either directly or via a conduit
  • first surgical rerouting of systemic venous inflow to the pulmonary circulation without a pumping ventricle was pioneered (in humans) by Dr Francis Fontan in 1968, as a palliative approach in three adult patients with tricuspid atresia
  • lateral tunnel baffling or extracardiac total cavopulmonary connection (TCPC) is now the staged surgical treatment of congenital heart diseases (CHDs) unsuitable for biventricular circulation either due to single ventricular anatomical cluster or adverse anatomical constraints (atrial isomerism, straddling atrioventricular valves and others)
  • ~95% survival rate at 10 years after Fontan surgery is reported

Reference:

• D'Angelo EC et al. Management of Fontan failure. Heart Published Online First: 16 August 2022. doi: 10.1136/heartjnl-2022-321006.