Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual
Volume 12, Issue 1 , Pages 94-98, 2009

Fontan or Septation: When I Abandon Septation in Complex Lesions With Two Ventricles

  • Richard A. Jonas

      Affiliations

    • Corresponding Author InformationAddress correspondence to Richard A. Jonas, MD, Department of Cardiac Surgery, Children's National Heart Institute, 111 Michigan Ave NW, Washington, DC 20010

Chief, Cardiac Surgery, Children's National Medical Center, Washington, DC

As the long term results of the lateral tunnel Fontan procedure, as well the extracardiac Fontan procedure, continue to improve, the threshold for shifting to a single ventricle track in the setting of a complex and non-ideal biventricular repair alternative has been lowered. Two ventricle options that subject the child and family to multiple surgical procedures and lengthy hospitalizations, as well a limited cardiac output because of ventricular hypoplasia or AV valve hypoplasia, should be avoided. This article will review the complex decision making that is required in the gray area between a clear biventricular pathway and the single ventricle track for patients with two ventricles.

Keywords: Decision making, single ventricle track, Fontan procedure, biventricular repair

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PII: S1092-9126(09)00008-8

doi:10.1053/j.pcsu.2009.01.007

Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual
Volume 12, Issue 1 , Pages 94-98, 2009