Fontan Procedure

This operation was devised by M. Fontan in the late 1960's for the treatment of children with tricuspid atresia. These children have only a single pumping chamber and therefore the surgical strategy is to separate the body and lung circulation by redirecting the blood returning from the head via the superior vena cava and the lower body via the inferior vena cava directly into the lungs leaving the ventricle to pump into the aorta. The operation was later applied to any child who only had a single pumping chamber.

The operation is now usually done in two parts the first being a cavo-pulmonary shunt at 6-12 months of age to connect the SVC to the pulmonary artery. The IVC is linked up to the lung artery as the second part a few years later - usually about 4-5 years of age.

There have been many modifications to the original operation given various names such as total cavo-pulmonary shunt, lateral tunnel, extra cardiac conduit but all share the same basic concept.

These angiograms were undertaken with an injection into the SVC (left) and the IVC (right) and demonstrate that the venous return is passing directly to the pulmonary arteries.

This page was last edited 14/2/2004

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