Fontan Circulation of the Next Generation: Why It's Necessary, What it Might Look Like

Kutty, Shelby; Jacobs, Marshall L.; Thompson, W. L.; Danford, David A.

doi:10.1161/jaha.119.013691

Cited by 40 publications

(36 citation statements)

References 63 publications

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“…Em suma, pode-se concluir que pacientes com fístulas coronário-cavitárias de repercussão devam ser reparados precocemente e os submetidos ao princípio Fontan, mesmo de menor repercussão, devem ser monitorados e investigados por testes de esforço em acompanhamento rigoroso. 9…”

Section: Discussionunclassified

Jovem de 17 Anos com Atresia Pulmonar e Septo Ventricular Íntegro, Submetido à Operação de Fontan e com Persistência da Fístula Coronário-Cavitária

Atik¹

2021

Arquivos Brasileiros De Cardiologia

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Section: Discussionunclassified

Jovem de 17 Anos com Atresia Pulmonar e Septo Ventricular Íntegro, Submetido à Operação de Fontan e com Persistência da Fístula Coronário-Cavitária

Atik¹

2021

Arquivos Brasileiros De Cardiologia

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“…5 One large Fontan series showed that only 24% remained free from arrhythmia at 30 years post-op, with 5% of patients having sudden cardiac death likely explained by arrhythmia. 11,12 Management of arrhythmias may be difficult in Fontan patients, with some papers suggesting high rates of complications from anti-arrhythmic drugs, such as dofetilide causing torsades de pointes, 13 and amiodarone causing thyrotoxicosis with greater frequency than seen in the non-ACHD population. 14 Consultation with electrophysiology specialists experienced in ACHD management may be beneficial.…”

Section: Fontan Circulationmentioning

confidence: 99%

Perioperative Management of the Fontan Patient for Cardiac and Noncardiac Surgery

McNamara

McMahon

Griffin

2022

Journal of Cardiothoracic and Vascular Anesthesia

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…6 The Fontan was originally performed without "preparation" of the single ventricle. 7 The single stage Fontan is now rarely performed, due to overall higher mortality rates.…”

Section: The Stage II Procedures and Physiologic Implicationsmentioning

confidence: 99%

Superior Cavopulmonary Connection: Its Physiology, Limitations, and Anesthetic Implications

Choi

DiNardo

Brown

2020

Semin Cardiothorac Vasc Anesth

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The superior cavopulmonary connection (SCPC) or “bidirectional Glenn” is an integral, intermediate stage in palliation of single ventricle patients to the Fontan procedure. The procedure, normally performed at 3 to 6 months of life, increases effective pulmonary blood flow and reduces the ventricular volume load in patients with single ventricle (parallel circulation) physiology. While the SCPC, with or without additional sources of pulmonary blood flow, cannot be considered a long-term palliation strategy, there are a subset of patients who require SCPC palliation for a longer interval than the typical patient. In this article, we will review the physiology of SCPC, the consequences of prolonged SCPC palliation, and modes of failure. We will also discuss strategies to augment pulmonary blood flow in the presence of an SCPC. The anesthetic considerations in SCPC patients will also be discussed, as these patients may present for noncardiac surgery from infancy to adulthood.

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Fontan Circulation of the Next Generation: Why It's Necessary, What it Might Look Like

Cited by 40 publications

References 63 publications

Jovem de 17 Anos com Atresia Pulmonar e Septo Ventricular Íntegro, Submetido à Operação de Fontan e com Persistência da Fístula Coronário-Cavitária

Jovem de 17 Anos com Atresia Pulmonar e Septo Ventricular Íntegro, Submetido à Operação de Fontan e com Persistência da Fístula Coronário-Cavitária

Perioperative Management of the Fontan Patient for Cardiac and Noncardiac Surgery

Superior Cavopulmonary Connection: Its Physiology, Limitations, and Anesthetic Implications

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