Management of the Fontan circulation in the adult patient

Clift, Paul

doi:10.24170/10-4-1779

Cited by 2 publications

(2 citation statements)

References 130 publications

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“…Delayed complications can be cardiac (progressive exercise intolerance, ventricular failure, arrhythmias, sudden cardiac death), conduit-related (conduit stenosis, thrombosis, wall calcification), vascular (PAVM, aortopulmonary collaterals [APC], pulmonary thromboembolism), hepatic (hepatic congestion, cardiac cirrhosis, regenerative liver nodules), and lymphovascular ( Table 1 ). 22) 23) …”

Section: Complications and Their Imaging Featuresmentioning

confidence: 99%

Computed Tomography in the Evaluation of Fontan Circulation

Kumar

Bhatia

2021

J Cardiovasc Imaging

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The Fontan procedure is a well-established surgical technique to improve survival in patients with univentricular heart disease. The procedure reroutes the systemic venous flow to the lungs, bypassing the right ventricle. The originally proposed method involved direct anastomosis of the right atrium to the pulmonary artery. Since then, several modifications have been made in the original technique leading to the modern Fontan, or total cavopulmonary connection. The modern Fontan technique has shown improved surgical outcomes and increased life expectancy in patients with univentricular disease. Due to the increased survival of these patients, long-term complications are becoming more prevalent. Common complications of Fontan procedure include right atrial dilatation and thrombosis; conduit stenosis and thrombosis; right-to-left and left-to-right shunts; hepatic congestion and cirrhosis; and lymphovascular. Computed tomography (CT) can reliably depict the normal Fontan anatomy and various postoperative complications. A fundamental understanding of the techniques of CT, including imaging protocols and common interpretive pitfalls, allows targeted imaging and precise reporting of clinically significant findings. Radiologists should be familiar with the multiple stages of single-ventricle palliation, normal Fontan anatomy, pathophysiology, and imaging features of common Fontan-related complications.

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Section: Complications and Their Imaging Featuresmentioning

confidence: 99%

Computed Tomography in the Evaluation of Fontan Circulation

Kumar

Bhatia

2021

J Cardiovasc Imaging

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“…More in depth description of the types of congenital defects that require a Fontan procedure, types of Fontan, and management of patients with Fontan circuits can be found in an article by Paul Clift. 5 Various techniques have been used to isolate and connect the right atrium or right atrial appendage to the pulmonary artery, collectively termed an atriopulmonary Fontan circuit. In this procedure the right atrium is anastomosed directly to the main pulmonary artery, which is divided proximally, obliterating its connection with the right ventricle 6 (Fig 3).…”

Section: History and Anatomymentioning

confidence: 99%