Since the initial description of the Fontan operation in 1971
1
for patients with single-ventricle physiology, our understanding of the modified
natural history of this population has grown immensely. Initial advances in optimising
surgical techniques based on the most common early complications were aimed at surviving
childhood. Over time, some patients began to survive into early adulthood, which led
to the focus on important sources of morbidity in early adulthood—specifically Fontan
failure, ventricular dysfunction, and arrhythmias. In turn, this led paediatric and
adult congenital cardiologists to concentrate on improving medical management and
interventional approaches, including catheter ablation. The comorbidities associated
with long-term venous hypertension are now becoming clearer. The failing Fontan remains
a challenge for cardiologists across the lifespan, and medical therapies and advances
in ventricular assist devices and heart transplantation have emerged as important
options in the therapeutic armamentarium for this difficult problem. In this issue
of Canadian Journal of Cardiology, we have assembled a collection of manuscripts that encapsulate current understanding
of Fontan physiology, the clinical progression of these patients over the lifespan,
and current approaches to deal with the complexities that arise in this circulatory
state.To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Canadian Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Surgical repair of tricuspid atresia.Thorax. 1971; 26: 240-248
- Hypoplastic left heart syndrome across the lifespan: clinical considerations for care of the fetus, child, and adult.Can J Cardiol. 2022; 38: 930-945
- Prenatal diagnosis and management of single-ventricle heart disease.Can J Cardiol. 2022; 38: 897-908
- Surgical strategies in single ventricle management of neonates and infants.Can J Cardiol. 2022; 38: 909-920
- Neurodevelopment and cognition across the lifespan in patients with single-ventricle physiology: abnormal brain maturation and accumulation of brain injuries.Can J Cardiol. 2022; 38: 977-987
- Exercise training for people living with Fontan circulation: an underutilized intervention.Can J Cardiol. 2022; 38: 1012-1023
- Quality of life and other patient-reported outcomes across the lifespan among people with Fontan palliation.Can J Cardiol. 2022; 38: 963-976
- Coagulation and anticoagulation in Fontan patients.Can J Cardiol. 2022; 38: 1024-1035
- Hepatic and renal consequences of single-ventricle physiology palliated with the Fontan operation.Can J Cardiol. 2022; 38: 1002-1011
- Management of patients with single-ventricle physiology across the lifespan: contributions from magnetic resonance and computed tomography imaging.Can J Cardiol. 2022; 38: 946-962
- Catheter ablation of atrial arrhythmias in patients post-Fontan.Can J Cardiol. 2022; 38: 1036-1047
- Cardiac implantable electronic devices in the Fontan patient.Can J Cardiol. 2022; 38: 1048-1058
- Considerations in critical-care and anesthetic management of adult patients living with Fontan circulation.Can J Cardiol. 2022; 38: 1100-1110
- Reproductive issues in patients with the Fontan operation.Can J Cardiol. 2022; 38: 921-929
- The Fontan circulation: from ideal to failing hemodynamics and drug therapies for optimization.Can J Cardiol. 2022; 38: 1059-1071
- Plastic bronchitis and protein-losing enteropathy in the Fontan patient: evolving understanding and emerging therapies.Can J Cardiol. 2022; 38: 988-1001
- Ventricular assist device use in single-ventricle circulation.Can J Cardiol. 2022; 38: 1086-1099
- Heart transplant indications, considerations, and outcomes in Fontan patients: age-related nuances, transplant listing, and disease-specific indications.Can J Cardiol. 2022; 38: 1072-1085
Article info
Publication history
Published online: May 20, 2022
Accepted:
May 16,
2022
Received:
May 13,
2022
Footnotes
See page 857 for disclosure information.
Identification
Copyright
© 2022 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
