Kutty S et al: Role of imaging in the evaluation of single ventricle with the Fontan palliation. Heart. 102(3):174-83, 2016
Burkhart HM et al: The Fontan operation: is timing everything? Semin Thorac Cardiovasc Surg. 27(2):175-6, 2015
Navarro-Aguilar V et al: Fontan procedure: imaging of normal post-surgical anatomy and the spectrum of cardiac and extracardiac complications. Clin Radiol. 70(3):295-303, 2015
Harris MA et al: Pre-Fontan cardiac magnetic resonance predicts post-Fontan length of stay and avoids ionizing radiation. J Thorac Cardiovasc Surg. 138(4):941-7, 2009
Gaca AM et al: Repair of congenital heart disease: a primer-part 1. Radiology. 247(3):617-31, 2008
Goo HW et al: Time-resolved three-dimensional contrast-enhanced magnetic resonance angiography in patients who have undergone a Fontan operation or bidirectional cavopulmonary connection: initial experience. J Magn Reson Imaging. 25(4):727-36, 2007
Rodríguez E et al: Postoperative imaging in cyanotic congenital heart diseases: part 1, Normal findings. AJR Am J Roentgenol. 189(6):1353-60, 2007
Festa P et al: The role of magnetic resonance imaging in the evaluation of the functionally single ventricle before and after conversion to the Fontan circulation. Cardiol Young. 15 Suppl 3:51-6, 2005
Related Anatomy
Loading...
Related Differential Diagnoses
Loading...
References
Tables
Tables
KEY FACTS
Terminology
Imaging
TERMINOLOGY
Synonyms
Total cavopulmonary connection
Definitions
Goal is to direct systemic venous return to pulmonary circulation directly, bypassing right heart
Initially described by Dr. Francis Fontan in 1968
Used in single ventricle physiology
Tricuspid atresia
Hypoplastic left heart syndrome
Double-inlet ventricle
Some heterotaxies
Stage 3 of Norwood procedure
Typically performed between 18-36 months of age
Originally described as extracardiac valved conduit between right atrium & left pulmonary artery
In combination with Glenn shunt, creates physiologic correction of blood flow
Superior vena cava (SVC) blood directed to right pulmonary artery & inferior vena cava (IVC) blood directed to left pulmonary artery
Complications of classic Fontan
Right atrial enlargement & hypertension
Impaired ventricular function
↓ pulmonary vascular blood flow
Tricuspid valve insufficiency
In order to preserve ventricular & pulmonary vascular function, modified Fontan now favored
Lateral tunnel Fontan
Intraatrial tunnel created in right atrium using prosthetic material
IVC anastomosed to caudal aspect of tunnel
Pulmonary artery anastomosed to cephalad aspect of tunnel
Extracardiac conduit Fontan (typically favored)
IVC divided from right atrium
Synthetic graft tube connected to IVC inferiorly & right pulmonary artery superiorly; travels along side of right atrium
In either form, IVC blood directed to pulmonary circulation, bypassing right heart structures
Small fenestration often created between Fontan circuit & right atrium
Kutty S et al: Role of imaging in the evaluation of single ventricle with the Fontan palliation. Heart. 102(3):174-83, 2016
Burkhart HM et al: The Fontan operation: is timing everything? Semin Thorac Cardiovasc Surg. 27(2):175-6, 2015
Navarro-Aguilar V et al: Fontan procedure: imaging of normal post-surgical anatomy and the spectrum of cardiac and extracardiac complications. Clin Radiol. 70(3):295-303, 2015
Harris MA et al: Pre-Fontan cardiac magnetic resonance predicts post-Fontan length of stay and avoids ionizing radiation. J Thorac Cardiovasc Surg. 138(4):941-7, 2009
Gaca AM et al: Repair of congenital heart disease: a primer-part 1. Radiology. 247(3):617-31, 2008
Goo HW et al: Time-resolved three-dimensional contrast-enhanced magnetic resonance angiography in patients who have undergone a Fontan operation or bidirectional cavopulmonary connection: initial experience. J Magn Reson Imaging. 25(4):727-36, 2007
Rodríguez E et al: Postoperative imaging in cyanotic congenital heart diseases: part 1, Normal findings. AJR Am J Roentgenol. 189(6):1353-60, 2007
Festa P et al: The role of magnetic resonance imaging in the evaluation of the functionally single ventricle before and after conversion to the Fontan circulation. Cardiol Young. 15 Suppl 3:51-6, 2005
STATdx includes over 200,000 searchable images, including x-ray, CT, MR and ultrasound images. To access all images, please log in or subscribe.