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Pediatric Fontan Procedure

The Fontan procedure is a surgery that changes the way blood flows between a child’s heart and lungs. Babies with certain heart defects like hypoplastic left heart syndrome need this surgery because half of their hearts don’t work properly. Children’s HealthSM is among a select few pediatric hospitals in the country with a Fontan Program dedicated to helping these children enjoy their healthiest lives possible.

What is the Fontan procedure?

The Fontan procedure is the last surgery in a series of three open-heart procedures necessary to treat children born with certain types of single ventricle defects. These congenital heart diseases occur when one of the heart’s two lower chambers (ventricles) doesn’t fully develop.

With the Fontan procedure, our experienced heart surgeons make a new connection that allows blood from your child’s lower body to go directly to the pulmonary arteries in the lungs to get oxygen. Typically, blood passes through the heart before going to the lungs.

The Fontan procedure typically takes place when a child is between 18 and 36 months of age. Your child may need the Fontan procedure if they have:

What are the benefits of the Fontan procedure?

The Fontan procedure is part of a series of lifesaving procedures for babies with certain single ventricle defects. These defects allow blood that’s too low in oxygen to circulate throughout a child’s body. Over time, this low oxygen can lead to heart failure and other types of organ failure.

The Fontan procedure allows blood from a child’s lower body to flow directly to arteries in the lungs to get oxygen. This oxygen-rich blood then goes to the heart. Even though half of the heart still doesn’t work properly, the heart’s working chambers can pump the oxygen-rich blood to the body.

What are the risks of the Fontan procedure?

Children’s Health has deep experience in performing the Fontan procedure and minimizing risks to your child. Still, any type of heart surgery carries a risk of blood clots, infections and other problems.

What to expect with the Fontan procedure

Children’s Health is home to one of the nation’s first and most experienced dedicated Fontan Programs. Though many children enjoy active lives after the Fontan procedure, the surgery doesn’t cure the heart defect. With our program, your child receives ongoing, comprehensive care from a team of specialists dedicated to promoting an active childhood and healthy adulthood.

What to expect before the Fontan procedure

Most babies with hypoplastic left heart syndrome or other single left ventricle defects get the Fontan procedure when they’re between 18 and 36 months old. At this point, your child will have already undergone two other heart procedures:

  1. The Norwood procedure takes place within the first week after birth. During this surgery, we reconstruct the aorta to allow blood to flow from the heart to the rest of the body. We also make a connection for blood to reach the lungs to pick up oxygen.
  2. The Glenn procedure takes place when your baby is 4 to 6 months old. We make a connection between the superior vena cava (a large blood vessel) and blood vessels in the lungs. This procedure enables blood from the upper body to reach the lungs to get oxygen.

What to expect during the Fontan procedure

During a Fontan procedure, one of our highly skilled pediatric heart surgeons:

  • Disconnects the inferior vena cava from the heart. This large vein carries oxygen-poor blood from your child’s lower body to the heart.
  • Uses a tube to reattach the inferior vena cava to the heart’s pulmonary artery.

What to expect after the Fontan procedure

For 2 to 3 weeks, your child recovers and grows stronger in the state’s largest pediatric cardiac intensive care unit (CICU) at Children’s Health. Here, your child receives dedicated care from some of the state’s best cardiologists and cardiac nurses.

We help you learn how to care for your child’s surgical incision and medication needs as you prepare to take your child home. Our unique Safe at Home program helps you manage your child’s care after leaving the hospital. Our medical team is available whenever you need us.

What questions should I ask my provider about the Fontan procedure?

  • How many Fontan procedures have you performed?
  • What is the success rate?
  • Are there other treatment options for my child’s heart condition?
  • Will my child need additional heart procedures? If so, when?
  • How soon will I be able to see my child after surgery?
  • What should I expect during my child’s recovery?

Pediatric Fontan Procedure Doctors and Providers

Frequently Asked Questions

  • Will my child need other surgeries after the Fontan procedure?

    People who had a Fontan procedure before the 1980s (when surgeons changed the surgery, making it even more effective and safe) are more likely to need a follow-up procedure called a Fontan revision. The old way of doing the surgery led to an increased risk of arrhythmias (irregular heartbeats) and other problems. Children who get the Fontan procedure today are unlikely to have these problems and shouldn’t need a Fontan revision.

  • Will my child need a heart transplant?

    In rare instances, a child may need a heart transplant. Some adults who had the Fontan procedure during infancy may eventually need a heart transplant. At Children’s Health, we monitor your child’s heart health for the rest of their life to help detect problems quickly. We have an expert heart transplant team and an Adult Congenital Heart Disease Program that provides ongoing, comprehensive care for people who have had the Fontan procedure.

  • How does a single ventricle heart defect and surgery affect my child’s development?

    Even with corrective surgery, your child may need to limit certain physical activities. Your child’s cardiologist can determine what activities are safe.