TY - JOUR
T1 - The Fontan Procedure
T2 - Evolution in Technique; Attendant Imperfections and Transplantation for "Failure"
AU - Davies, Ryan R
AU - Chen, Jonathan M.
AU - Mosca, Ralph S.
PY - 2011
Y1 - 2011
N2 - Application of the Fontan procedure has allowed the survival of many patients with univentricular cardiac lesions into mid adulthood. Despite its ingenious design, implementation, and thoughtful modifications, its attendant hemodynamic perturbations persist; central venous hypertension and reduced cardiac output. These aberrations in physiology have led to pernicious changes in organ function. A more thorough understanding of these derangements and attempts at Fontan revision have temporized, yet the morbidity and patient attrition persists. Mechanical assistance to normalize the circulation is being investigated and holds some promise. At present, cardiac transplantation remains the last stage of palliation for many.
AB - Application of the Fontan procedure has allowed the survival of many patients with univentricular cardiac lesions into mid adulthood. Despite its ingenious design, implementation, and thoughtful modifications, its attendant hemodynamic perturbations persist; central venous hypertension and reduced cardiac output. These aberrations in physiology have led to pernicious changes in organ function. A more thorough understanding of these derangements and attempts at Fontan revision have temporized, yet the morbidity and patient attrition persists. Mechanical assistance to normalize the circulation is being investigated and holds some promise. At present, cardiac transplantation remains the last stage of palliation for many.
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U2 - 10.1053/j.pcsu.2011.01.014
DO - 10.1053/j.pcsu.2011.01.014
M3 - Article
C2 - 21444050
AN - SCOPUS:79953044452
SN - 1092-9126
VL - 14
SP - 55
EP - 66
JO - Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual
JF - Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual
IS - 1
ER -