Fig. 49.1
Illustration of the modified extracardiac Fontan operation. The superior vena cava has been disconnected from the right atrium and anastomosed to the right pulmonary artery. A graft has been interposed between the inferior vena cava and the left pulmonary artery. This graft also has been anastomosed in a side-to-side fashion with the right pulmonary artery. Permanent pacemaker leads have been attached to the right atrial appendage and the ventricle
In some patients a small communication (“fenestration”) is created between the inferior vena cava to pulmonary artery connection and the pulmonary venous atrium. Patients who have had a “fenestrated Fontan” operation continue to have a right-to-left shunt and are mildly cyanotic. The fenestration reduces some of the postoperative complications and may reduce the risk of late development of protein-losing enteropathy.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
