From the Guidelines
The Fontan procedure is a palliative surgical intervention for patients with univentricular heart defects, creating a new circulatory system that connects the systemic venous return to the pulmonary arteries, bypassing the right ventricle. This procedure is mainly used in patients with congenital univentricular heart disease when a biventricular repair is not feasible, as described in the Journal of Hepatology 1. The Fontan-type techniques create a new circulatory system (Fontan circulation) connecting the systemic venous return from both the inferior and superior vena cava and the pulmonary arteries, avoiding the right ventricle, which will passively transmit the blood through the lungs to the single ventricular chamber.
Key Points of the Fontan Procedure
- The procedure was first described in 1971 for patients with tricuspid atresia 1
- It is used for a variety of univentricular heart defects
- The original approach consisted of closing the atrial septal defect and connecting the atria to the pulmonary arteries
- The procedure creates a passive circulation system where blood flows to the lungs due to pressure differences rather than ventricular pumping
Clinical Implications
- The Fontan procedure is typically the final stage in a series of palliative surgeries for children born with a functional single ventricle 1
- Patients require lifelong anticoagulation therapy to prevent clot formation in this modified circulation
- Regular cardiology follow-ups are essential to monitor for potential complications such as arrhythmias, protein-losing enteropathy, or ventricular dysfunction 1
From the Research
Fontana Procedure
- The Fontana procedure is not mentioned in the provided studies 2, 3, 4, 5, 6.
- The studies discuss various retinal detachment repair techniques, including pneumatic retinopexy 3, 6, scleral buckling 2, 4, 5, and laser photocoagulation 3, 4, 5.
- However, there is no information available on the Fontana procedure in the given evidence.
Related Procedures
- Pneumatic retinopexy is a minimally invasive procedure for repairing uncomplicated rhegmatogenous retinal detachment 3, 6.
- Scleral buckling is a surgical technique used to repair retinal detachments by placing a flexible band around the eye 2, 4, 5.
- Laser photocoagulation is a procedure used to treat retinal breaks and prevent further detachment 3, 4, 5.
Study Findings
- Pneumatic retinopexy has a single-operation success rate ranging from 45 to 80% 6.
- Scleral buckling and pars plana vitrectomy have been compared to pneumatic retinopexy in terms of functional outcomes 6.
- The choice of retinopexy method (cryotherapy or laser photocoagulation) can affect visual recovery and postoperative complications 4, 5.