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The bidirectional Glenn and Fontan procedures—integrated management of the patient with a functionally single ventricle

Published online by Cambridge University Press:  19 August 2008

Richard D. Mainwaring ,
John J. Lamberti  and
John W. Moore
Richard D. Mainwaring*
Affiliation:
The Cardiac Institute, Children's Hospital–San Diego, San Diego
John J. Lamberti
Affiliation:
The Cardiac Institute, Children's Hospital–San Diego, San Diego
John W. Moore
Affiliation:
The Cardiac Institute, Children's Hospital–San Diego, San Diego
*
Dr. Richard D. Mainwaring, 3030 Children's Way, Suite 310, San Diego, CA 92123, USA. Fax 619-974-8032.
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Abstract

The Fontan procedure provides a means of separating the systemic and pulmonary circulations in patients with congenital heart defects characterized by a functionally single ventricle. The procedure has undergone numerous changes since its introduction 25 years ago. Technical modifications have now increased its applicability to virtually all forms of univentricular atrioventricular connection, as well as many hearts with biventricular connections. More recently, philosophical changes have been introduced to address increased rates of morbidity and mortality observed in certain subsets of patients. These changes appear to have improved short- and midterm results. The purpose of this review is to offer our strategy for management of such patients. We will discuss the interrelationship between the bidirectional Glenn and Fontan procedures. We will also focus on a number of observations concerning the possible role of accessory pulmonary blood flow, aortopulmonary collateral arteries, and endocrinologic changes.

Keywords

Single ventricleFontan procedureGlenn procedurebidirectional Glenn procedurehemi-Fontan procedure
Type
Review Article
Information
Cardiology in the Young , Volume 6 , Issue 3 , July 1996 , pp. 198 - 207
Copyright
Copyright © Cambridge University Press 1996

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