- The Fontan procedure routes venous return directly into the pulmonary circulation
- Fontan is used for patients with single-ventricle physiology (i.e. only 1 functional ventricle), e.g. hypoplastic left heart syndrome and tricuspid atresia
- Involves the IVC being disconnected from the RA and connected to the pulmonary artery.
- Often, they’ll create a fenestration (hole between the IVC conduit and the RA to provide an additional shunt (pop-off valve).
- Once completed, the blood flow through the lungs is completely through the Fontan circuit: SVC + IVC → pulmonary arteries (flow is passive and continuous - remember the example of CTA to assess for PE that DeZorzi presented!).
- The single ventricle is responsible for pumping blood to the body only.
Figure source
Great video detailing Fontan procedure fron Cincinnati Children’s: