What is a normal Fontan pressure?
Typical pressures in a well compensated young patient with a Fontan circulation are a CVP (mPAP) of 12 mm Hg and atrial pressure of 5 mm Hg, so giving a transpulmonary pressure gradient of about 7 mm Hg.
What does the Fontan surgery do?
During a Fontan surgery, congenital heart surgeons reroute the blood flow from the lower body to the lungs by connecting the inferior vena cava to the pulmonary artery. To accomplish this, surgeons will most often create a connecting channel, or tube, outside of the heart.
How old is the oldest Fontan patient?
The oldest survivor after the Fontan operation was 67 years of age (Fontan at age 39 years). Of the 723 follow-up questionnaires mailed out, 305 (42%) were returned.
What is Extracardiac Fontan?
The extracardiac Fontan uses an external conduit to anastomose the inferior vena cava into the pulmonary arteries, whereas a lateral tunnel Fontan uses a baffle within the right atrium (Figure 1).
How long do Fontan patients live?
The average age of the adult Fontan cohort at Mayo Clinic is 30 to 35 years.
What happens when Fontan fails?
Late Fontan failure may present insidiously over years. It is a failure of medical management to interpret the absence of overt symptoms or ascites as evidence of optimal haemodynamic status in the functionally univentricular circulation.
What is a high Fontan pressure?
High systemic venous pressure is the essence of the Fontan paradox where a higher than normal systemic venous pressure is necessary to maintain pulmonary blood flow. In failing Fontan, this systemic venous hypertension is transmitted to the venous and the lymphatic circulation.
Does exercise increase CVP?
Central venous pressure (CVP) gives the integral result of changes in cardiac and peripheral factors. Thus, the sudden increase in CVP observed at the onset of dynamic exercise has been attributed to the action of the muscle pump but is also affected by reflex changes in cardiac response.
What is a Fontan fenestration?
During the Fontan procedure, the surgeon: Disconnects the inferior vena cava (IVC) from the heart and connects it to the pulmonary artery using a conduit (tube). Makes a small hole between the conduit and the right atrium. This hole (or fenestration) lets some blood still flow back to the heart.
What is Fontan failure?
The Australian and New Zealand Fontan Registry (ANZFR) defines Fontan failure as the occurrence of death, heart transplant, protein-losing enteropathy (PLE), plastic bronchitis or New York Heart Association (NYHA) Functional class III or IV at follow-up.
How successful is Fontan procedure?
A review of 86 patients who underwent Fontan procedures at Mayo Clinic and who received 152 direct current cardioversions for treatment of atrial arrhythmias, published in International Journal of Cardiology in April 2016, showed that cardioversion was successful in 73 percent of the patients, and the success rate was …
Who gets a Fontan procedure?
The Fontan procedure is a type of open-heart surgery. Children who need this surgery usually have it when they’re 18–36 months old.