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Review
. 2014 May;7(2):120-5.
doi: 10.4103/0974-2069.132480.

The Hemi-Fontan operation: A critical overview

Sachin Talwar  1 , Vinitha Viswambharan Nair  1 , Shiv Kumar Choudhary  1 , Balram Airan  1
Affiliations
Review

The Hemi-Fontan operation: A critical overview

Sachin Talwar et al. Ann Pediatr Cardiol. 2014 May.

Abstract

The hemi-Fontan (HF) operation is a staging procedure in the journey towards an ultimate Fontan palliation. Although popular in the Western world, it has found limited application in the developing world. In this review we discuss the indications, techniques, merits, and demerits of this procedure along with its present day role in developing world where there is lack of awareness about this operation.

Keywords: Fontan; single ventricle; superior cavopulmonary anastomosis.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Cross-sectional view of the HFP. HFP = Hemi-Fontan procedure. Reproduced with permission from: Bando K, et al.; Ann Thorac Surg 2000;69:1873-9
Figure 2
Figure 2
Path lines corresponding to SVC injection for HFP (upper panel) and BDG (lower panel) models. Lines are color coded with reference to velocity magnitude (red for high velocity and blue for low velocity). SVC = Superior vena cava, BDG = Bidirectional Glenn. Reproduced with permission from: Bove EL, et al. J Thorac Cardiovasc Surg 2003;126:1040-7
Figure 3
Figure 3
Modified hemi-Fontan operation. (a) The opened roof of the right atrium, including the stump of SVC, is anastomosed in end-to-side fashion to the inferior wall pulmonary artery, creating the blind connection. (b) Bidirectional cavopulmonary anastomosis is centrally located. Incision of medial aspect of cardiac end of SVC is carried horizontally well beyond the junction of SVC and right atrium. IVC = Inferior vena cava, LPA = Left pulmonary artery. Reproduced with permission from: Hraska V. Interact CardioVasc Thorac Surg 2003;2:379-81
Figure 4
Figure 4
Percutaneous Fontan completion. (a) Angiogram following stent and ASD device placements within the lateral atrial tunnel. ASD = Atrial septal defect, RPA = Right pulmonary artery, STENT = Balloon-mounted bare stent, DEVICE = Amplatzer ASD occlusion device. (b) Angiographic image delineating the pericardial patch on the floor of the pouch opposite to the bidirectional cavopulmonary connection. PATCH = Autologous pericardial patch, APERTURE = Aperture in medial wall of lateral tunnel Reproduced with permission from: Sallehuddin A, et al. Fontan completion without surgery. Eur J Cardiothorac Surg 2007;32:195-201
See this image and copyright information in PMC

References

    1. Rodbard S, Wagner D. By-passing the right ventricle. Proc Soc Exp Biol Med. 1949;71:69–70. - PubMed
    1. Fontan F, Baudet E. Surgical repair of tricuspid atresia. Thorax. 1971;26:240–8. - PMC - PubMed
    1. Jacobs ML, Rychik J, Rome JJ, Apoustopoulou S, Pizarro C, Murphy ID, et al. Early reduction of the volume work of the single ventricle: The hemi fontan operation. Ann Thorac Surg. 1996;62:456–62. - PubMed
    1. Fontan F, Fernandez G, Costa F, Naftel DC, Tritto F, Blackstone EH, et al. The size of the pulmonary arteries and the results of the Fontan operation. J Thorac Cardiovasc Surg. 1989;98:711–9. - PubMed
    1. Jacobs ML, Pelletier GJ, Pourmoghadam KK, Mesia CI, Madan N, Stern H, et al. Protocols associated with no mortality in 100 consecutive Fontan procedures. Eur J Cardiothorac Surg. 2008;33:626–32. - PubMed