Document Detail


Medical management of the failing Fontan.
MedLine Citation:
PMID:  17763892     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The Fontan operation accomplishes complete separation of systemic venous blood from pulmonary venous circulation in patients with single ventricle anatomy. Operative survival since the first description of the Fontan operation is excellent in the current era through modifications in surgical techniques, identification of patient-specific risk factors, and advances in postoperative care. Improved early outcomes have also resulted in a decline in late mortality for patients who have undergone staged palliation with the Fontan operation. As the number of late survivors from the Fontan operation increases, caregivers will be evermore faced with the challenge of recognizing and managing the patient with failing Fontan physiology. Even after excellent early results, patients with single ventricle lesions remain at risk of progressive ventricular dysfunction, dysrhythmias, progressive hypoxemia, elevated pulmonary vascular resistance, and protein-losing enteropathy, which can result in morbidities including but not limited to, myocardial failure, thromboembolism, and stroke. Consequently, continued long-term survival of patients who undergo the Fontan operation is dependent upon preservation of single ventricle function, avoidance of late complications, and, in the patient with a failing Fontan, recognition and treatment of the underlying pathophysiologic process that has resulted in Fontan failure.
Authors:
N S Ghanayem; S Berger; J S Tweddell
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Pediatric cardiology     Volume:  28     ISSN:  0172-0643     ISO Abbreviation:  Pediatr Cardiol     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2007-11-20     Completed Date:  2008-02-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  465-71     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Division of Critical Care, Children's Hospital of Wisconsin and Medical College of Wisconsin, 9000 West Wisconsin Avenue, MS 681, Milwaukee, WI 53226, USA. nghanayem@aol.com
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MeSH Terms
Descriptor/Qualifier:
Anoxia / etiology,  therapy
Fontan Procedure / adverse effects*
Heart Defects, Congenital / mortality*,  therapy*
Humans
Incidence
Lung Diseases / etiology,  therapy
Protein-Losing Enteropathies / etiology,  therapy
Risk Factors
Treatment Failure
Vascular Resistance / drug effects
Ventricular Dysfunction / etiology,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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