The First Fontan Procedure For Palliation Of Single Ventricle ( Sv )

1434 Words Apr 13th, 2016 6 Pages
Introduction
Fontan and Baudet detailed in their article the first Fontan procedure in the early seventies [1]. Since then, the Fontan procedure has been applied for palliation of single ventricle (SV) patients. Multiple modifications of the original procedure were introduced to improve morbidity and mortality. Short and long term outcomes of the Fontan procedure were studied heavily by numerous investigators [2, 3]. Wellbeing of SV patients, following Fontan palliation, going into adolescent and adulthood was the core of multiple meetings in the 21th century. This kind of meetings was dictated by the need for modified care plans suitable for the growing number of adult patients who underwent this palliative procedure [4-7].
One of the risk factors of failing Fontan is the presence of aorto-pulmonary collateral arteries (APCs). APCs are present in up to 80% of SV patients undergoing pre-Fontan catheterization. Pre-Fontan coil closure of these vessels decreases SV volume load and improves outcome after Fontan procedure [8-10]. These collateral vessels are usually branches of the right and left subclavian arteries, including the left internal mammary artery (LIMA) and the right internal mammary artery (RIMA). Branches of the subclavian arteries and intercostal arteries normally have extensive anastomotic connections with LIMA and RIMA. Successful occlusion of the APCs requires obliteration of the whole length of the vessel to prevent revascularization by distal feeder…

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