Tricuspid Atresia and Fontan Operation - TA : Heart Disease : Heart Disease Online

	From your Guide Dr.MANI
*Tricuspid Atresia*

	home	\|	disease	\|	webcast	\|	latest	\|	links
	news	\|	archive	\|	contact	\|	books	\|	disclaimer


NEW ! Special Report Dr.Mani's AFTER THE FONTAN *How Fontan survivors fare in the long term*	Visit website Request details Order a copy
If your child - someone you love very much - has had the Fontan operation, you must have often wondered what the future holds ... Can my child study ? Play ? Work ? Marry ? Have kids ? YOU NEED MORE INFORMATION ! Dr.Mani's NEW report, AFTER THE FONTAN, deals with survival after the Fontan, quality of life issues and complications of the Fontan procedure. To learn more about this essential report, CLICK HERE

What are the kinds of Fontan-type operations ?

Ever since its first description, the Fontan operation has been modified many times. Each modification aimed to avoid one of the drawbacks of the previous types. While some are definitely better, others are not very different. We are still striving to devise the "best" type of Fontan repair for each group or individual.
As I mentioned earlier, in the original Fontan operation, the venous blood was diverted to the lungs directly from the right atrium, and the ASD was closed. While Dr.Fontan used an artificial valve between the inferior vena cava (IVC) and the right atrium, future modifications eliminated this.

The aims of the "ideal" Fontan operation are

To achieve a smooth stream-lined blood flow from veins to the lungs
To retain growth potential as the child becomes older
To avoid use of artificial materials
To be adaptable to patients of any age group.

Total Cavo-pulmonary Connection (TCPC) operation

A group of surgeons in the United Kingdom has come up with a detailed computer simulation program, and this software allows creation of a computer generated image of the heart after the different modifications of the Fontan operation, to allow study of blood flow patterns with each. The type that allows smooth flow will be preferred because less energy is wasted by "turbulence", and allows more energy to be used for achieving lung blood flow.
Based on their experimental studies performed earlier, this group suggested the idea of a LATERAL TUNNEL FONTAN repair. In this, a "tunnel" is created within the right atrium using an artificial fabric patch. The tunnel links the superior and inferior vena cava (SVC and IVC) to each other. The tunnel is then connected to the pulmonary artery. Because of this, the operation is also called TOTAL CAVO-PULMONARY CONNECTION - or TCPC. The advantage with this technique is that blood flow is laminar, and energy loss due to turbulent flow is least, and thus improving lung blood flow.

Later improvements of the TCPC operation have allowed

Construction of the tunnel with the patient's own heart tissue, avoiding use of artificial fabric
Creating the tunnel "outside" the right atrium, avoiding an incision in the atrium
Performance of the operation without using the heart lung machine - almost like a closed heart operation.

Fenestrated Fontan operation

home	\|	disease	\|	webcast	\|	latest	\|	links
news	\|	archive	\|	contact	\|	books	\|	disclaimer

Member of the Internet Link Exchange