Principles of the fontan conversion operation

Constantine Mavroudis, Barbara J. Deal, Carl L. Backer

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The sequelae of Fontan-type repairs for functionally univentricular hearts include hemodynamic changes related to atrial enlargement and underlying anatomy, arrhythmias, and multiorgan system effects. Therapeutic interventions addressing both hemodynamic sequelae and arrhythmia substrates have been effective in improving quality of life and markedly reducing arrhythmia recurrence during midterm follow-up. Successful arrhythmia intervention requires careful assessment of the arrhythmia mechanisms and application of the appropriate surgical ablation techniques. The surgical intervention is challenging owing to redo sternotomy in univentricular physiology and anatomic variations. This chapter outlines the authors’ resternotomy and operative techniques for safe mediastinal reentry and the surgical and anatomic variants encountered in association with Fontan conversion.

Original languageEnglish (US)
Title of host publicationPediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care
PublisherSpringer-Verlag London Ltd
Pages2589-2608
Number of pages20
ISBN (Electronic)9781447146193
ISBN (Print)9781447146186
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Keywords

  • Accessory connections
  • Arrhythmia
  • Atrial enlargement
  • Atrial fibrillation
  • Atrioventricular nodal reentry tachycardia
  • Extracardiac total cavopulmonary connection
  • Hemodynamic repair
  • Resternotomy
  • Surgical ablation techniques
  • Univentricular hearts

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Mavroudis, C., Deal, B. J., & Backer, C. L. (2014). Principles of the fontan conversion operation. In Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care (pp. 2589-2608). Springer-Verlag London Ltd. https://doi.org/10.1007/978-1-4471-4619-3_187