Pediatric Fontan Revision

Years after a Fontan procedure for single ventricle disease, doctors may find that the heart has developed an arrhythmia (irregular heartbeat). The Fontan revision can address this and other complications that may affect blood circulation.

At Children's Health℠, we work with many adults who have had a previous Fontan procedure. We have extensive experience with these complex procedures and can skillfully manage the care that they require.

What is Pediatric Fontan Revision?

The Fontan procedure was developed in 1968 to treat hearts that developed with a single ventricle (pumping chamber). The procedure was modified in the late 1980s. Sometimes hearts that received the original Fontan procedure need to have a second operation to revise the circulation of blood through the heart. One solution is a procedure called a Fontan revision, which can address side effects that can follow an older Fontan procedure.

Fontan revisions are usually done on teens or adults who had a Fontan procedure when they were toddlers. This procedure typically greatly improves symptoms that may have developed and can prevent the need for a heart transplant. Fontan procedures performed since the 1970s and 1980s are less likely to require a Fontan revision. However, some patients may need other follow-up procedures.

What are the benefits of Pediatric Fontan Revision?

The Fontan revision improves the circulation of blood through the Fontan circuit. After the revision, a patient typically has less liver congestion, and fewer heart rhythm issues (known as heart arrhythmia) and other heart problems. The revision can also make it easier for people to be physically active.

What are the risks of Pediatric Fontan Revision?

This procedure involves the same risks of other heart surgery or repeated heart surgery, such as bleeding, infections and stroke.

What to expect with Pediatric Fontan Revision?

Fontan revisions tend to be like other heart operations.

What to expect before a Pediatric Fontan Revision?

A patient will have a preoperative visit the day before the procedure. They will have basic laboratory tests and bloodwork. The morning of the procedure, they will be brought to the operating room.

What to expect during a Pediatric Fontan Revision?

A Fontan revision usually takes all day. The surgery involves general anesthesia. There is a breathing tube placed to help a patient breathe and chest tubes to drain fluids from around the heart and lungs.

What to expect after a Pediatric Fontan Revision?

After the procedure, a patient will be brought to the Cardiac Intensive Care Unit (CICU) and will probably stay in the hospital for a few weeks. The care team should be able to remove the breathing tube within a day or so. They can remove the other tubes over the next few days.

What questions should I ask my provider about Pediatric Fontan Revision?

  • How many Fontan revisions have you performed?
  • What problems can the Fontan revision address?
  • How does a patient usually feel after having a Fontan revision?

Pediatric Fontan Revision Doctors and Providers

Children’s Health is home to the largest team of pediatric cardiology and congenital heart defect experts in the region. Our comprehensive team that can treat all aspects of your child’s condition.

Frequently Asked Questions

  • Will another Fontan Revision be necessary in the future?

    No. This procedure makes the heart circulation more efficient. A second revision will not be necessary.

  • How does the Fontan Revision change the way the heart works?

    The revision usually makes the blood move from the body through the lungs and then to the heart more efficiently than the original Fontan. This procedure is called an extracardiac conduit, because the blood travels to the lungs through a tube added outside the heart.