Pediatric Fontan revision

Years after a Fontan procedure for single ventricle disease, doctors may find that the heart has developed an arrhythmia (irregular heartbeat). The Fontan revision can address this and other complications that may affect blood circulation.

At Children's Health℠, we work with many adults who have had a previous Fontan procedure. We have extensive experience with these complex procedures and can skillfully manage the care that they require.

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What is a pediatric Fontan revision procedure?

The Fontan procedure was developed in 1968 to treat hearts that developed with a single ventricle (pumping chamber). The procedure was modified in the late 1980s. Sometimes hearts that received the original Fontan procedure need to have a second operation to revise the circulation of blood through the heart. One solution is a procedure called a Fontan revision, which can address side effects that can follow an older Fontan procedure.

Fontan revisions are usually done on teens or adults who had a Fontan procedure when they were toddlers. This procedure typically greatly improves symptoms that may have developed and can prevent the need for a heart transplant. Fontan procedures performed since the 1970s and 1980s are less likely to require a Fontan revision. However, some patients may need other follow-up procedures.

What are the benefits of a pediatric Fontan revision procedure?

The Fontan revision improves the circulation of blood through the Fontan circuit. After the revision, a patient typically has less liver congestion, and fewer heart rhythm issues (known as heart arrhythmia) and other heart problems. The revision can also make it easier for people to be physically active.

What are the risks of a pediatric Fontan revision procedure?

This procedure involves the same risks of other heart surgery or repeated heart surgery, such as bleeding, infections and stroke.

What to expect with a pediatric Fontan revision procedure?

Fontan revisions tend to be like other heart operations.

What to expect before a pediatric Fontan revision procedure

A patient will have a preoperative visit the day before the procedure. They will have basic laboratory tests and bloodwork. The morning of the procedure, they will be brought to the operating room.

What to expect during a pediatric Fontan revision procedure

A Fontan revision usually takes all day. The surgery involves general anesthesia. There is a breathing tube placed to help a patient breathe and chest tubes to drain fluids from around the heart and lungs.

What to expect after a pediatric Fontan revision procedure

After the procedure, a patient will be brought to the Cardiac Intensive Care Unit (CICU) and will probably stay in the hospital for a few weeks. The care team should be able to remove the breathing tube within a day or so. They can remove the other tubes over the next few days.

What questions should I ask my provider about a pediatric Fontan revision procedure?

How many Fontan revisions have you performed?
What problems can the Fontan revision address?
How does a patient usually feel after having a Fontan revision?