The Fontan procedure is performed as the final stage of palliation for patients with
single-ventricle congenital heart diseases, such as tricuspid atresia, hypoplastic
left-heart syndrome, or severely unbalanced atrioventricular canal defect. It creates
a functional series circulation in which all pulmonary blood flow is derived from
the systemic venous return that subsequently supplies ventricular preload in the absence
of a subpulmonic pumping chamber. Since its inception in 1971, surgical advancement
in the Fontan procedure has led to improved long-term outcomes, with transplant-free
survival reaching 84% at 20 years.
1
,2
There are an estimated 28,000 adult patients with Fontan physiology alive worldwide,
a population that is expected to double within 20 years.
3
,4
Many of these patients are females of childbearing age, making pregnancy and childbirth
in the parturient with Fontan physiology a reality.
5
Key Words
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Article info
Publication history
Published online: July 14, 2022
Footnotes
Research reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number T32HL007411. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
All authors provided final approval of the submitted manuscript and agree to be accountable for all aspects of the work. Additional author contributions are as follows: D.E.C. was responsible for study conceptualization and design; data acquisition, interpretation, and analysis; drafting the article and all subsequent revisions; G.S., K.C., S.D., S.H., B.F., J.T., and A.J.W. were responsible for data interpretation; critical revisions; R.D.B. and C.J. were responsible for study design; data acquisition and interpretation; critical revisions; and S.E. was responsible for study conceptualization and design; data acquisition, interpretation, and analysis; critical revisions.
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- Assessing the Fontan Parturient; One Size Does Not Fit AllJournal of Cardiothoracic and Vascular AnesthesiaVol. 37Issue 1
