Fontan Procedure

The Fontan procedure is the final one in a series of surgeries performed by Norton Children’s Heart Institute cardiovascular surgeons to treat hypoplastic left heart syndrome (HLHS) or patients with complex single ventricles. Advances in treating single ventricle patients have given more babies the chance to live full lives. For example, hypoplastic left heart syndrome was considered inoperable and fatal before surgeons developed the three-surgery series.

The goal of the Fontan procedure is to direct blood from the lower part of the body directly to the lungs. The route bypasses the heart preventing deoxygenated blood from mixing with oxygenated blood which previously caused lower oxygen saturations. The cardiothoracic surgeons at Norton Children’s Heart Institute are skilled at rebuilding the heart and redirecting blood flow so the heart isn’t overworked and more oxygen-rich blood is distributed throughout the body.

The board-certified and fellowship-trained cardiothoracic surgeons at Norton Children’s Heart Institute are equipped to perform the Fontan procedure as part of HLHS treatment.

How the Fontan Procedure Works

Surgeons performing the Fontan procedure disconnect the inferior vena cava (the vein that brings blood back from the lower part of the body) from the heart and connect it to the pulmonary artery.

Often, a small hole, called a fenestration, is created between the conduit and the right atrium. This allows some blood to flow directly back to the heart. It acts as a relief valve as the lungs get used to the extra flow from the lower part of the body. The fenestration can be closed later in life with a cardiac catheterization procedure.

With all the connections made, blood from the lower body now goes to the pulmonary artery, and then to the lungs, without having to go to the heart. The patient’s single ventricle now pumps oxygen-rich blood from the lungs out to the body and all the way back through the lungs.

With the high- and low-oxygen blood no longer mixing in the heart because of the defect, more oxygen gets out to the body.

Children who have the Fontan procedure usually spend one to two weeks in the hospital to recover. They also get medicines to help the heart and improve blood flow. The physicians and staff at Norton Children’s Hospital provide around-the-clock care and monitoring.

What Else You May Need to Know

Many children born with single ventricles thrive and do well after the series of heart surgeries. However, they’ll need to still see thier pediatric cardiologists, get echocardiograms, and occasional cardiac catheterizations.

To help keep your child as healthy as possible:

  • Go to all doctor visits.
  • Give all medicines as directed.
  • Follow the guidelines from your care team.

Sometimes, the three heart surgeries do not completely fix all the issues with the heart, or the single ventricle can wear out because it is always performing the workload of two ventricles. In these cases, a child may need a heart transplant.

Why Norton Children’s Heart Institute?

Norton Children’s Heart Institute, affiliated with the University of Louisville, is a comprehensive pediatric heart surgery, heart failure and heart transplant program serving Kentucky, Southern Indiana and beyond.

The goal of the full-service Norton Children’s Heart Institute is to provide care for the child and the whole family. Our specialists are prepared to repair even the most complex congenital and acquired heart conditions.

Our heart team includes:

  • Pediatric cardiothoracic surgeons
  • Pediatric transplant surgeons
  • Pediatric cardiologists
    • Fetal cardiologists
    • Adult congenital heart cardiologists
    • Heart failure/heart transplant cardiologists
    • Pediatric electrophysiologists
    • Pediatric cardiac catheterization cardiologists
  • Pediatric cardiovascular anesthesiologists
  • Pediatric intensive care physicians
  • Cardiac critical care nurses
  • Critical care pharmacists
  • Family support team
  • Child life specialists
  • Rehabilitation specialists
  • Social workers
A child with a single ventricle defect also needs the Fontan procedure because of these reasons.
An illustration shows changes to the IVC during the Fontan procedure
An illustration shows the right ventricle after the Fontan procedure
Heart – 2929

Norton Children’s Heart Institute

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(502) 629-2929

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