What is the Fenestrated Fontan procedure ?
One other major modification was suggested by Drs.Hillel Laks and Bridges. This is the
FENESTRATED FONTAN operation. When the Fontan operation has to be done in children
who have an elevated lung blood vessel resistance, the outcome is unlikely to be good. This is
because lung blood flow after operation will be low. Also, the pressure of blood in the veins will
increase to maintain lung blood flow. And this elevated vein pressure has its own ill effects.
To avoid such problems, it was suggested that a "hole" be left in the fabric patch used to create the
tunnel. Through this hole, the tunnel could "decompress" into the left atrium whenever the pressure
in the tunnel becomes dangerously high.
What are the pros and cons of a fenestrated Fontan operation ?
While this causes a reduction in oxygen content in arterial blood, it still avoids sudden decrease in
the amount of blood pumped by the heart. This modification has proved life-saving in many cases,
and has allowed a much wider usage of the Fontan operation in borderline cases. After some time,
when the patient's condition has stabilized, this hole can be closed using trans-catheter techniques
or by tightening a purse-string stitch that had been placed at the time of surgery.
To learn about the modification of the Fontan operation called a Bidirectional Glenn shunt, read
the next article in this series.
