Developed in the early 1970s, the Fontan procedure is used to treat congenital heart defects that have only one side of the heart that is functional. Surgeons at the Walt Disney Pavilion at Florida Hospital for Children use the procedure to divert venous (unoxygenated) blood to the pulmonary arteries without a pumping chamber. The propelling force through the pulmonary circulation is determined by venous pressure. The single functional ventricle serves as a pump to the rest of the body to deliver oxygen and nutrients.
The procedure is normally performed on young patients in two or three stages. The first stage is usually a systemic to pulmonary artery shunt whereby a systemic artery is connected to the pulmonary arteries by way of a Goretex tube graft. At about 6 months of age, the shunt is removed and replaced during a procedure known as the bidirectional Glenn shunt in which the superior vena cava blood flow is directed to the pulmonary arteries after the main pulmonary artery has been detached from the heart. The third stage takes place at about 2 and a half years of age and is known as the Fontan operation.
Because the body still may not be receiving adequate levels of oxygen, the Fontan operation directs the blood from the inferior vena cava, which carries oxygen-depleted blood from the lower body, to the lungs. As a result, the blood can be reoxygenated in the lungs without having to be pumped out using the pressure in your child’s veins alone. Surgeons use this procedure to direct all the venous blood flow to the pulmonary arteries thereby dividing the venous and arterial circulations. This leaves a single ventricle to supply oxygenated blood to the body and establishes proper oxygen levels.
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