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Fontan procedure is a surgery for individuals born with only one functioning heart ventricle. Following the surgery, the pulmonary artery is the only blood vessel that receives oxygen-poor blood from the body, bypassing the heart chambers. Most patients live for 30 years or more following the surgery.
Who is the best candidate for the Fontan procedure?
Children aged 2 to 15 (generally between 3 and 5) with a single ventricle condition may need a Fontan procedure. However, it’s not suitable for everyone. A healthcare provider will determine if your child is a good candidate by ensuring their working ventricle is strong enough to pump effectively and their lungs are healthy enough to handle passive blood flow.
Classification
Following are the different types of Fonton Procedures:
- Atriopulmonary Connection involves connecting the right atrium directly to the pulmonary arteries.
- Lateral Tunnel Fontan: This method uses an intracardiac tunnel within the atrium to direct blood flow to the pulmonary arteries.
- Extracardiac Conduit Fontan: This method uses the heart by joining the inferior vena cava to the pulmonary arteries, bypassing the heart.
The Fontan procedure is palliative surgery for the hearts of children with complex congenital heart defects where one ventricle is functional. Examples include tricuspid atresia, hypoplastic left heart syndrome, and other single-ventricle conditions. It redirects venous blood flow to the pulmonary artery, bypassing the heart, to improve blood oxygenation and decrease the workload on a single ventricle.
Single-ventricle physiology is usually diagnosed shortly after birth or during fetal screening. Parents should consult a pediatric cardiologist early so the child can be monitored and a plan for surgery can be developed. Poor weight gain, bluish discolouration of the skin (cyanosis), extreme tiredness, and difficulty breathing are some symptoms that require immediate review.
Preparation includes complete preoperative evaluation with echocardiography, cardiac catheterisation, and blood tests. The child may even have had staged operations (such as Norwood, Glenn) before Fontan. They will be instructed about medications, nutritional support, and measures to prevent infections before surgery.
Under general anesthesia, the surgeons connect the inferior vena cava (which carries deoxygenated blood from the lower part of the body) directly to the pulmonary artery, facilitating passive blood flow to the lungs. This can be done either via a lateral tunnel or an extracardiac conduit. The heart-lung machine is used during surgery.
The complexity of the Fontan operation largely depends on the state of the child and the surgery itself. Hence, it usually takes 4 to 6 hours to perform. Variations in surgical time may occur if preceding operations have been performed or if any complications arise.
- Arrhythmias
- Bleeding
- Infection
- Pleural effusion (fluid around the lungs)
- Low cardiac output
- Blood clots
Fontan greatly increases oxygenation, resulting in its sky-high appeal in cases of single ventricular defects, where cyanosis is a serious drawback.
Patients spend 1 to 2 days in the ICU, followed by 1 to 2 weeks of hospitalisation. Blood thinners and other medicines to maintain fluid balance and heart functioning usually continue at home. Follow-ups include regular cardiac imaging, lab monitoring, and advice on activities.
The Fontan procedure achieves a survival rate of over 90% for well-selected patients, especially with the introduction of advanced surgical techniques and postoperative care. Long-term survival into adulthood is possible, but lifelong follow-up under an adult cardiologist is necessary.
Top Selling Packages for Fontan Procedure
Fontan
Amrita Hospital, Faridabad, India
USD 6200 USD 6700
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Mount Elizabeth Novena Hospital
Novena, Singapore
Mount Elizabeth Novena Hospital located in Novena, Singapore is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- Capacity of 333 beds
- Intensive Care Unit beds
- Endoscopy beds
- Day ward with 20 beds
- 13 Operating Theatres, which includes 1 Neurological operating room, 2 Cardiac operating rooms, 4 Orthopaedic operating rooms, etc.
- High Dependency Unit (HDU)
- Neonatal Intensive Care Unit (NICU)
- 24/7 Accident & Emergency Department
- Maternity ward
- 1 major operating unit with 13 operating rooms inclusive of 1 hybrid theatre
- In-house Pharmacy
- Rooms are categorized as Single Signature Rooms, Junior Suite and Regal Suite
- All patient rooms are equipped with electric safe, LCD, sofa cum bed, wardrobe, radio channels, and much more
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+99Process Involved for Fontan Procedure in Novena
- Evaluation & Preparatory Stage
- Medical Assessment: Detailed History
- Diagnostic Tests are performed for a better understanding.
- Medical Optimization
- Surgical Planning
- Surgical Stage
- General Anesthesia & Heart-Lung Bypass
- Creating the Fontan Circuit
- Surgical closure
- Postoperative Recovery
- Intensive Monitoring
- Pain & Infection Management
- Rehabilitation & Follow-Up Care
- Blocked Tricuspid Valve
- Blocked Pulmonary Valve
- Hypoplastic Left Heart Syndrome (HLHS)
- Double Inlet Left Ventricle (DILV)
- Single Ventricle Circulation
- Tricuspid atresia (Congenital Heart defect)
- Hypoplastic left heart syndrome (HLHS)
- Double inlet left ventricle (DILV)
- Patients who have undergone prior heart surgeries
- Norwood Procedure (Stage 1) : Performed in Newborn
- Bidirectional Glenn Shunt (Stage 2)
- Fenestration Creation (small opening)
- Pacemaker Implantation
- Improves Blood Oxygen Levels
- Reduces Heart Strain
- Enhances Physical Activity & Quality of Life
- Provides a Stable Long-Term Circulation
- Prevents the Need for Transplantation
- Pediatric Cardiac Surgeon
- Adult Cardiac Surgeon
- Pediatric Cardiologist
- Perfusionist
- Cardiologist
- Physiotherapist
- Rehabilitation Specialists
- Fill out the inquiry form: Fill out the form to provide us with the relevant information about your condition.
- Consult with Our Healthcare Expert:One of our qualified specialists will contact you for a consultation
- Receive a Detailed Treatment Plan:After examining your situation, we will provide you with a detailed treatment plan that includes expert views and cost breakdowns for various choices.
- Choose your preferred option: Choose the treatment option that suits you the best.
