Is Four Stage Management the Future of Univentricular Hearts? Destination Therapy in the Young

For the child born with a functionally univentricular heart, multi-stage surgical palliation culminating in the Fontan operation is now well established as the standard of care. Though this is an effective approach, there are several inherent disadvantages to the Fontan circulation: subnormal resting cardiac output, impaired exercise capacity, increased risk of thromboembolism, and increased risk of arrhythmia. Perhaps most importantly, the long-term deleterious effects of substantial systemic venous hypertension, which is necessary to “drive” blood through the pulmonary vascular bed, include progressive dysfunction of other organ systems, particularly renal, lymphatic, gastrointestinal, and hepatic systems.
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research