Disease relevance of Fontan Procedure

• Between 1968 and 1977, 32 patients who underwent the Fontan operation for tricuspid atresia at Bordeaux, France, or Leiden, The Netherlands, survived at least 1 year after surgery [1].
• The adjustable atrial septal defect is a modification of the Fontan procedure designed to improve cardiac output and reduce systemic venous hypertension during the postoperative period [2].
• Protein-losing enteropathy following the Fontan operation: resolution with prednisone therapy [3].
• Thrombosis of intracardiac or extracardiac conduits after modified Fontan operation in patients with azygous continuation of the inferior vena cava [4].
• Use of heparin in the treatment of protein-losing enteropathy after fontan operation for complex congenital heart disease [5].

High impact information on Fontan Procedure

• Enalapril does not enhance exercise capacity in patients after Fontan procedure [6].
• CONCLUSIONS: The Fontan procedure with unidirectional cavopulmonary connection and adjustable ASD has several advantages that may reduce mortality and morbidity for the high-risk Fontan candidate [7].
• The fenestrated Fontan operation improves survival in high-risk patients by increasing cardiac index and maintaining oxygen delivery, despite mild arterial O2 desaturation [8].
• Elevated atrial natriuretic peptide after the Fontan procedure [9].
• METHODS: We reviewed the outcomes of 94 consecutive patients who underwent the Fontan operation between 1977 and 1994 and were followed as adults at the University of Toronto Congenital Cardiac Centre for Adults [10].

Chemical compound and disease context of Fontan Procedure

• Atrial flutter in a pediatric patient in the immediate period after the Fontan procedure: control with oral propafenone [11].
• Nitric oxide in pulmonary arteriovenous malformations and Fontan procedure [12].
• The mean maintenance warfarin dosage was significantly lower in patients after the Fontan operation, with or without valvar replacement, in the absence of apparent liver dysfunction [13].
• This case report presents the occurrence of a malignant wide complex tachycardia after intravenous adenosine administration in a 10-year-old boy 2 days after a Fontan procedure [14].

Biological context of Fontan Procedure

• The aim of this study was to evaluate prospectively the effect of late atrial septal defect closure on cardiac output and oxygen delivery in patients who have undergone the Fontan procedure [15].
• The partial Fontan with an adjustable ASD may increase the safety of the Fontan procedure for high-risk groups such as those with increased pulmonary vascular resistance, pulmonary hypertension, and impaired left ventricular function and for infants, who tolerate venous hypertension poorly [16].
• CONCLUSIONS: Atrial natriuretic peptide is secreted in response to elevated central venous pressure after the Fontan procedure, but its concentration might not be sufficient [17].
• CONCLUSIONS: Imbalance between increased ET-1 and relatively decreased adrenomedullin after cardiopulmonary bypass in the Fontan procedure could contribute to dominant effects of ET-1, which might induce vasoconstriction after the Fontan procedure [18].
• METHODS: Through the cardiology and cardiovascular surgery databases of The Hospital for Sick Children and Toronto Congenital Cardiac Centre for Adults, we identified patients with trisomy 21 and ventricular hypoplasia who had undergone a Fontan procedure (or modification) [19].

Anatomical context of Fontan Procedure

• Nitric oxide synthase expression by pulmonary arteries: a predictive marker of Fontan procedure outcome [20]?
• These lesions were correctly diagnosed preoperatively, and "correction" was achieved by closing the atrial septal defect and tricuspid valve and performing a Fontan procedure using an antibiotic-sterilized aortic homograft for the conduit [21].
• Permanent pacing of the left ventricle was achieved by transvenous implantation of a steroid-eluting electrode into the coronary sinus in a patient who had undergone a Fontan operation [22].
• Development of superior vena cava to pulmonary vein fistulae following modified Fontan operation: case report of a rare anomaly and embolization therapy [23].

Associations of Fontan Procedure with chemical compounds

• In 12 patients who underwent the Fontan procedure for complex cardiac anomalies, lung scanning with xenon-133 was performed to assess the intrapulmonary ventilation-perfusion distribution, and comparison was made with a control group [24].
• The effect of prednisone in adult patients with PLE after the Fontan procedure is largely unknown [25].
• All had absent resting and isoproterenol-provoked pressure gradient before the Fontan procedure [26].
• Is captopril useful in decreasing pleural drainage in children after modified Fontan operation [27]?
• The role of vasopressin and atrial natriuretic factor in postoperative fluid retention after the Fontan procedure [28].

Gene context of Fontan Procedure

• Time course of endothelin-1 and adrenomedullin after the Fontan procedure [18].
• METHODS: Levels of factors V, VII, VIII, X, antithrombin III, prothrombin fragment F1+2, protein C, and protein S were measured in 2 groups of patients: In 14 patients undergoing the Fontan procedure, blood was analyzed before the operation and 5 days after the operation (group 1) [29].
• RESULTS: Concentrations of protein C; factors II, V, VII, and X; plasminogen; and antithrombin III were significantly lower before the Fontan operation compared with age-matched controls (p < 0.01); no specific hemodynamic variables were predictive of a pro- or anticoagulant deficiency [30].
• In the absence of such obstruction, banding the pulmonary trunk can be performed at reasonable risk and, provided that the ventricular septal defect is of adequate size, satisfactorily prepares most patients for a later Fontan procedure [31].
• Forty-seven adult patients were seen late after the Fontan operation at the Toronto Congenital Cardiac Centre for Adults [32].

Analytical, diagnostic and therapeutic context of Fontan Procedure

• Prolonged high frequency jet ventilation and milrinone therapy following modified Fontan procedure [33].
• Combined therapy with inhaled nitric oxide and intravenous epoprostenol (prostacyclin) for critical pulmonary perfusion after the Fontan procedure [34].
• The mean age at the time of the Fontan operation and at transplantation was 7.3 +/- 2.8 and 17.2 +/- 6.3 years, respectively [35].
• We tested the latter hypothesis by determining venous vascular capacitance at rest and during orthostatic stress produced by lower body negative pressure (LBNP) in 6 subjects who had undergone the Fontan operation and 6 healthy age-, sex-, height-, and weight-matched controls [36].

References