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The Fontan circulation: a challenge to William Harvey?

Nature Clinical Practice Cardiovascular Medicine volume 2, pages 202–208 (2005)Cite this article

Abstract

The Fontan operation, which places the systemic and pulmonary circulations in series and is driven by a single ventricular chamber, is the treatment of choice for patients born with one ventricle. Its introduction 35 years ago was the result of a flurry of experimental and clinical research that had started in the 1940s. A large number of children have benefited and continue to benefit from the Fontan operation, but there is a genuine concern that, despite the refinement of the surgical procedures in the past 20 years, continuing attrition might be inevitable. This adverse effect can lead to a decline in functional capacity, and premature late death.

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Figure 1: The different types of Fontan circulation.
Figure 2: Schematic model of the Fontan circulation.
Figure 3: Path lines of intracardiac and extracardiac total cavopulmonary connection.
Figure 4: The circulation of the lung.

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  1. Professor of Cardiothoracic Surgery, Great Ormond Street Hospital for Children NHS Trust, London, UK

    Marc R de Leval

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  1. Marc R de Leval
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Correspondence to Marc R de Leval.

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de Leval, M. The Fontan circulation: a challenge to William Harvey?. Nat Rev Cardiol 2, 202–208 (2005). https://doi.org/10.1038/ncpcardio0157

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