© 2005 by BMJ Publishing Group & British Cardiac Society
EDITORIAL
Prophylactic anticoagulation following the Fontan operation
Adult Congenital Heart Programme, Department of Cardiology, Royal Brompton Hospital, and the National Heart & Lung Institute, Imperial College, London, UK
Correspondence to:
Correspondence to:
Dr Michael A Gatzoulis
Adult Congenital Heart Programme, Department of Cardiology, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; m.gatzoulis@rbh.nthames.nhs.uk
Is it possible to advise either for or against prophylactic anticoagulation in patients following Fontan surgery?
Keywords: anticoagulation; Fontan; thromboembolism
| The first 150 words of the full text of this article appear below. |
The Fontan procedure was first successfully performed in 1971 in a patient with tricuspid atresia,1 and has become the preferred approach for surgical palliation in patients in whom a biventricular circulation is not possible. The underlying principle is to divert the systemic venous return directly to the pulmonary arteries, thereby reducing volume overload of the single ventricle and increasing systemic oxygenation. The initial operation utilised a Glenn anastomosis with placement of valved conduits between the right atrium and ventricle and the right ventricle and pulmonary artery. The technique has undergone many modifications attempting to reduce early mortality and morbidity.
A modification that is still encountered frequently in adult patients is the connection of the right atrium to the pulmonary artery either directly or via a conduit. It had been assumed that incorporation of the pulsatile atrial chamber into the circuit would assist flow into the pulmonary circulation. In reality, atrial
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Epidemiology
-
Drugs: cardiovascular system
-
Interventional cardiology
-
Congenital heart disease
-
Echocardiography
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
