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The Fontan procedure is the final surgery in a series to treat babies with hypoplastic left heart syndrome (HLHS) or other complex single-ventricle conditions. Advances in treating single ventricles have given more babies the chance to live full lives. For example, HLHS was considered inoperable and fatal before surgeons developed the three-surgery series.
The goal of the Fontan procedure is to direct blood from the lower part of the body directly to the lungs. The route bypasses the heart, preventing deoxygenated blood from mixing with oxygenated blood, which previously caused lower oxygen saturations.
The board-certified and fellowship-trained cardiothoracic surgeons at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, are skilled at rebuilding the heart and redirecting blood flow so the heart isn’t overworked and more oxygen-rich blood is distributed throughout the body. Our cardiothoracic surgeons are equipped to perform the Fontan procedure as part of HLHS treatment.
Los cirujanos que realizan el procedimiento de Fontan desconectan la vena cava inferior (la vena que devuelve la sangre desde la parte inferior del cuerpo) del corazón y la conectan a la arteria pulmonar.
A menudo, se crea un pequeño orificio, llamado “fenestración”, entre el conducto y la aurícula derecha. Esto permite que un poco de sangre circule directamente de regreso al corazón. Actúa como una válvula de escape mientras los pulmones se acostumbran al flujo adicional de la parte inferior del cuerpo. The fenestration can be closed later in life with a cardiac catheterization procedure.
With all the connections made, blood from the lower body now goes to the pulmonary artery and then to the lungs, without having to go to the heart. El ventrículo único del paciente ahora bombea sangre oxigenada desde los pulmones hacia el resto del cuerpo y de regreso a través de los pulmones.
Dado que la sangre con alto y bajo contenido de oxígeno ya no se mezcla en el corazón debido a la anomalía, llega más oxígeno al cuerpo.
Los niños que se someten al procedimiento de Fontan generalmente pasan una o dos semanas en el hospital para recuperarse. También reciben medicamentos para ayudar al corazón y mejorar el flujo sanguíneo. Los médicos y el personal del Norton Children’s Hospital brindan atención y seguimiento constantes.
Many children born with single ventricles thrive and do well after the series of heart surgeries. However, they’ll need to see their pediatric cardiologist, get echocardiograms and occasionally undergo cardiac catheterizations.
Growing into adulthood with this unique single-ventricle circulatory system can come with complications and risks affecting the liver, kidneys, heart or lungs.
The Norton Children’s Heart Institute Fontan Clinic provides regular follow-up and monitoring to help spot any emerging issue early and treat it sooner, when more options may be available.
The Fontan Clinic works in conjunction with the Norton Children’s Heart Institute’s adult congenital heart disease program to provide sophisticated care to patients born with heart conditions.
Para ayudar a mantener a su hijo lo más saludable posible:
Sometimes, the three heart surgeries do not completely fix all the issues with the heart, or the single ventricle can wear out because it is performing the workload of two ventricles. En estos casos, el niño podría necesitar un trasplante de corazón.