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The Fontan circulation: a challenge to William Harvey?


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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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).

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