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Chapter 30 - Failing Fontan

from Section 5 - Single-Ventricle Physiology

Published online by Cambridge University Press:  09 September 2021

By
Maricarmen Roche Rodriguez  and
Viviane G. Nasr
Edited by
Laura K. Berenstain  and
James P. Spaeth
Laura K. Berenstain
Affiliation:
Cincinnati Children's Hospital Medical Center
James P. Spaeth
Affiliation:
Cincinnati Children's Hospital Medical Center
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Summary

The Fontan procedure has been adapted as a palliation for a variety of congenital heart diseases that result in single-ventricle physiology. Complications after Fontan palliation are common and include exercise intolerance, hepatomegaly, lymphatic dysfunction with protein losing enteropathy, ventricular dysfunction, and rhythm and conduction disturbances. Patients with Fontan circulation are experiencing improved long-term outcomes and longer life expectancy and hence present more often for noncardiac surgery. A comprehensive understanding of the Fontan circulation is required in order to provide safe care to both well-functioning and failing Fontan patients in the perioperative period.

Keywords

anesthetic managementatriopulmonary connectionfailing FontanFontan physiologyhypoplastic left heart syndromenoncardiac surgerytotal cavopulmonary connection
Type
Chapter
Information
Congenital Cardiac Anesthesia
A Case-based Approach
 , pp. 226 - 238
Publisher: Cambridge University Press
Print publication year: 2021

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References

References

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Suggested Reading

Jolley, M., Colan, S. D., Rhodes, J., et al. Fontan physiology revisited. Anesth Anal 2015; 121: 172–82.CrossRefGoogle ScholarPubMed
Windsor, J., Townsley, M. M., Briston, D., et al. Fontan palliation for single-ventricle physiology: perioperative management for noncardiac surgery and analysis of outcomes. J Cardiothorac Vasc Anesth 2017; 31: 2296–303.CrossRefGoogle ScholarPubMed

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