Fontan physiology revisited

Anesth Analg. 2015 Jul;121(1):172-182. doi: 10.1213/ANE.0000000000000717.

Abstract

The Fontan operation places the systemic and pulmonary circulations in series, driven by a single ventricular chamber. It has become the treatment strategy of choice for palliating single-ventricle congenital heart disease. This anatomy engenders profound changes in physiology, affecting the cardiovascular and respiratory systems with direct implications for anesthetic and intensive care. The physical basis of these changes and their sequelae are reviewed.

Publication types

  • Review

MeSH terms

  • Adaptation, Physiological
  • Animals
  • Cardiopulmonary Resuscitation
  • Coronary Circulation*
  • Exercise Tolerance
  • Extracorporeal Membrane Oxygenation
  • Fontan Procedure* / adverse effects
  • Fontan Procedure* / mortality
  • Heart Defects, Congenital / mortality
  • Heart Defects, Congenital / physiopathology
  • Heart Defects, Congenital / surgery*
  • Hemodynamics*
  • Humans
  • Lung / blood supply*
  • Lung / physiopathology
  • Models, Cardiovascular
  • Myocardial Contraction
  • Postoperative Complications / mortality
  • Postoperative Complications / physiopathology*
  • Postoperative Complications / therapy
  • Pulmonary Circulation*
  • Pulmonary Ventilation
  • Risk Factors
  • Treatment Outcome
  • Ventricular Function