Fontan Procedure Schematic

A Fontan is done in most children (approximately 90%) who effectively have a single functional ventricle, either secondary to a hypoplastic ventricle, valvular atresia or a congenital syndrome.



Ultimately, the goal of the Fontan procedure is the following:



1) Staged rerouting of systemic venous return

2) Bypass the right heart, direct SVC flow into the pulmonary arteries.

3) Bypass the right heart, direct IVC flow into the pulmonary arteries.



This physiology is important, because in the adult patient who has had a Fontan, this creates a single ventricle that is providing cardiac output for pulmonary and systemic circulation. Ultimately, the right heart is completely bypassed, and there is passive laminar flow from the SVC and IVC into the pulmonary artery.



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