Interv Akut Kardiol 2019; 18(3, Suppl.A): 22-25 | DOI: 10.36290/kar.2019.047

Fontan circulation: „a common univentricle heart”

Petra Antonová¹, Tomáš Zatočil^2,3, Daniela Žáková^2,4, Vilém Rohn¹

¹ Centrum pro dospělé s vrozenou srdeční vadou, Klinika kardiovaskulární chirurgie FN Motol, Praha

² Centrum komplexní péče o vrozené vývojové vady v dospělosti, Brno

³ Interní kardiologická klinika, FN Brno

⁴ Centrum kardiovaskulární a transplantační chirurgie, Brno

The Fontan circulation is surgical solution of complicated heart defects in cases when it is not possible to maintain distinct systemic and pulmonary circulations. It involves several consecutive surgical operations, the final step being the attachment of the superior vena cava to a pulmonary artery branch and connection of the vena cava to the pulmonary artery through an intra-atrial or extracardiac tunnel. This gives rise to neoportal circulation comprising two capillary circulations in tandem, dependent on good systolic and diastolic function of the common ventricle, central venous pressure, and low pulmonary vascular resistance. Long-term survival of patients with the Fontan circulation is very good; however, morbidity is high. Frequent complications include heart failure, arrhythmias, and increased pulmonary vascular resistance that, alone or in combination, may lead to collapse of this delicate circulation. Moreover, damage to other systems often occurs, most commonly involving the liver function and haemostasis. Residual findings following primary surgery can be managed with surgery or catheterization; no evidence base exists for medical therapy.

Keywords: Fontan circulation, TCPC, pulmonary vascular resistance, common ventricle

Published: November 1, 2019  Show citation