Converting Fontan-Björk to 1.5- or 2-Ventricle Circulation

Ann Thorac Surg. 2019 Apr;107(4):e259-e261. doi: 10.1016/j.athoracsur.2018.07.097. Epub 2018 Oct 10.

Abstract

Patients with tricuspid atresia and ventricular septal defect have in the past occasionally undergone a Fontan with "Björk" modification to create a connection between the right atrium and the right ventricular outflow tract. Although rarely performed now, patients with this physiology often face severe complications requiring reintervention. We hypothesize that surgical conversion to a 2-ventricle or 1.5-ventricle circulation can improve hemodynamics, clinical status, and thus increase time to transplant. We present 2 successful cases to illustrate this idea.

MeSH terms

  • Abnormalities, Multiple / diagnostic imaging
  • Abnormalities, Multiple / surgery
  • Adult
  • Blalock-Taussig Procedure / adverse effects*
  • Blalock-Taussig Procedure / methods
  • Echocardiography, Three-Dimensional / methods
  • Follow-Up Studies
  • Fontan Procedure / methods*
  • Heart Atria / surgery
  • Heart Septal Defects, Ventricular / complications
  • Heart Septal Defects, Ventricular / diagnostic imaging
  • Heart Septal Defects, Ventricular / surgery*
  • Heart Ventricles / surgery
  • Hemodynamics / physiology*
  • Humans
  • Magnetic Resonance Imaging, Cine / methods
  • Male
  • Reoperation / methods*
  • Risk Assessment
  • Treatment Outcome
  • Tricuspid Atresia / complications
  • Tricuspid Atresia / diagnostic imaging
  • Tricuspid Atresia / surgery*