A heart with two atriums but one ventricle, an anatomy with a unique physiology, is responsible for many creative surgical and interventional approaches in history. Different surgical techniques have been used to address this strange physiology of parallel circulation. All these attempts met with failure till the concept of Fontan circulation was described. Currently, controversy exists between multistage vs. single stage total cavopulmonary connections. Total cavopulmonary connection is the only definitive procedure performed to provide palliation for patients with complex congenital heart defects which cannot support a biventricular circulation. We report a case with tricuspid atresia with transposition of great arteries and pulmonary stenosis with persistant left-sided superior vena cava and functionally single ventricle. Patient successfully underwent single stage extra-cardiac total cavopulmonary connection. In this case, bilateral Glenn with extra-cardiac inferior vena cava to main pulmonary artery shunt was performed off-pump.
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Diagnostics (Basel)
November 2024
Department of Pediatric Cardiac Surgery and Congenital Heart Disease, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico.
Background: Fontan circulation maintains an elevated venous pressure; this promotes venous and lymphatic congestion and may lead to late circuit failure. Our objective was to determine the association between thoracic lymphatic perfusion patterns assessed by magnetic resonance imaging and late Fontan failure.
Methodology: A retrospective study was performed.
Eur J Cardiothorac Surg
November 2024
Adult Congenital Heart Diseases Unit, Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas's NHS Foundation Trust, London, UK.
Objectives: There is dearth of data on long-term outcomes of systemic semilunar (SS) or atrioventricular (AV) valve operation in adult patients with a Fontan circulation. We describe a single-centre experience of adults who underwent valve surgery late after a Fontan procedure.
Methods: We retrospectively reviewed all patients with a Fontan circulation who had a reoperation for severe valve disease during adulthood in our centre.
J Am Heart Assoc
December 2024
Children's Health & Exercise Research Centre (CHERC) Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter Exeter United Kingdom.
Background: Peak oxygen consumption (peak O) is traditionally scaled by body mass, but it is most appropriately scaled by fat-free mass. However, it is unknown whether peak O scaled by fat-free mass is associated with mortality and morbidity in people with a Fontan circulation. The aim of this study was to assess the associations between different expressions of peak O with mortality and morbidity in people with a Fontan circulation.
View Article and Find Full Text PDFSci Rep
November 2024
Department of Pediatric Cardiology, University Children's Hospital, University of Tübingen, Tübingen, Germany.
Recent research in patients with functionally univentricular hearts (UVH) is focusing on pathologies of the lymphatic vessels. Morphology of the abdominal lymphatic vessels was analyzed by MRI in patients with UVH following total cavopulmonary connection (TCPC) and it was examined, if clinical and laboratory parameters correlate with changes after TCPC. We prospectively examined 33 patients at the age of 19.
View Article and Find Full Text PDFJ Am Heart Assoc
December 2024
Montreal Heart Institute, Université de Montréal Quebec Canada.
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