2020
DOI: 10.15420/usc.2019.20.2
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Single-Ventricle Physiology

Abstract: Single-ventricle physiology occurs in patients with hypoplastic ventricular heart defects, either on the right or left, who have undergone stepwise palliation surgeries ending with the Fontan procedure. After Fontan completion, these patients are dependent on passive venous return to the pulmonary circulation. The implications of passive flow are potentially devastating to the patient. We discuss some of the basic changes to the patient’s experience after a Fontan procedure, as well as the common complications… Show more

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“…This approach streamlined the returning blood flow and improved hemodynamics while decreasing adverse effects on the RA, however it still generated high pressures on the lateral wall, facilitating the creation of an arrhythmogenic substrate. The extracardiac approach was developed following the lateral tunnel, and in this procedure the routing conduit was moved from inside the atria to outside the heart itself, routing the IVC to the right pulmonary artery, which resolved the issues of increased pressure on the RA (and adverse sequelae), but by definition excludes catheter access to living atrial tissue [2,21,22] (Fig. 8, Supplemental Fig.…”
Section: The 'Nonexistent' Isthmus: Fontan Procedures In Univentricul...mentioning
confidence: 99%
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“…This approach streamlined the returning blood flow and improved hemodynamics while decreasing adverse effects on the RA, however it still generated high pressures on the lateral wall, facilitating the creation of an arrhythmogenic substrate. The extracardiac approach was developed following the lateral tunnel, and in this procedure the routing conduit was moved from inside the atria to outside the heart itself, routing the IVC to the right pulmonary artery, which resolved the issues of increased pressure on the RA (and adverse sequelae), but by definition excludes catheter access to living atrial tissue [2,21,22] (Fig. 8, Supplemental Fig.…”
Section: The 'Nonexistent' Isthmus: Fontan Procedures In Univentricul...mentioning
confidence: 99%
“…Although there are life-saving advantages to this approach, such as normal blood saturations, there are long-term physiologic adaptations that lead to adverse chronic conditions, such as systemic venous hypertension. In addition, these patients are almost completely dependent on heart rate and atrioventricular conduction to increase cardiac output, and they have very little hemodynamic reserve [2].…”
Section: The 'Nonexistent' Isthmus: Fontan Procedures In Univentricul...mentioning
confidence: 99%
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