Heart 1998;79:213-214 ( March )
Editorial
The Fontan procedure: lessons from the past
| The first 150 words of the full text of this article appear below. |
The Fontan circulation was one of the "big ideas" in congenital heart disease in the 1970s. This completely novel type of circulation was at first the source of some astonishment but, gradually, understanding of its properties progressed and there is now an expanding cohort of patients followed up with stable Fontan circulations.
In 1990, on the basis of an observational study of the survival and wellbeing of 334 patients, Fontan et al came to the disappointing conclusion that even after a perfect Fontan procedure there was a gradual decline in the functional status of patients that the authors could not attribute to anything other than the Fontan circulation itself.1 This and other long term follow up studies have provoked a wave of negativity about Fontan-type operations that has had repercussions for patients with complex anatomy facing radical operations.
Two European papers,2,3 describe cross sectional studies
of medium and long term survivors of
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