Fontan Procedure

1. What is the Fontan Procedure?

The Fontan procedure is the final stage of a staged surgical pathway for selected children born with complex congenital heart defects where one ventricle cannot adequately support both the pulmonary and systemic circulation.

2. When is it Recommended?

It may be recommended for selected patients with single-ventricle physiology, such as hypoplastic left heart syndrome, tricuspid atresia, pulmonary atresia with an intact ventricular septum and certain forms of unbalanced atrioventricular septal defects.

3. What Symptoms May a Patient Notice?

Depending on the underlying heart defect and stage of treatment, symptoms may include breathlessness, poor feeding, poor weight gain, bluish discoloration of the skin, fatigue, reduced exercise tolerance or recurrent hospitalisation for heart-related problems.

4. What Does the Treatment Involve?

The surgeon connects the veins returning blood from the lower part of the body to the pulmonary arteries, allowing blood to flow passively into the lungs without being pumped by a separate ventricle. The exact surgical technique depends on the patient's anatomy and previous operations.

5. What Are the Main Treatment Options?

The Fontan is usually the third stage of staged palliation, following procedures such as the Norwood procedure and Bidirectional Glenn (BD Glenn) procedure in appropriate patients. Different Fontan configurations, including lateral tunnel and extracardiac conduit, may be selected based on individual anatomy.

6. How Long Does Treatment & Recovery Take?

The operation commonly takes around 4–6 hours, although complex cases may take longer. Hospitalisation often lasts approximately 1–2 weeks, including time in the cardiac intensive-care unit. Recovery continues for several weeks after discharge.

7. What Are the Important Risks or Considerations?

The Fontan circulation is a specialised form of circulation rather than a complete anatomical correction. Potential complications include abnormal heart rhythms, blood clots, protein-losing enteropathy, pleural effusions, liver complications, reduced exercise capacity and Fontan failure. Long-term specialist follow-up is essential.

8. Why Consider Treatment in India?

India has specialised paediatric congenital heart centres with multidisciplinary teams experienced in staged single-ventricle surgery, including Fontan procedures, cardiac imaging, paediatric cardiac intensive care and long-term congenital heart follow-up.

9. How Can Medavelle Help?

Medavelle can assist with echocardiography and cardiac imaging review, paediatric cardiologist and cardiac surgeon coordination, congenital heart centre selection, surgical planning, international patient arrangements and postoperative follow-up coordination.

10. What Should the Patient Do Next?

Share cardiac reports → Paediatric cardiology evaluation → Single-ventricle assessment → Fontan suitability evaluation → Treatment planning in India.