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State of the art of the Fontan strategy for treatment of univentricular heart disease
In patients with a functionally univentricular heart, the Fontan strategy achieves separation of the systemic and pulmonary circulation and reduction of ventricular volume overload. Contemporary modifications of surgical techniques have significantly improved survival. However, the resulting Fontan...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
F1000 Research Limited
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024235/ https://www.ncbi.nlm.nih.gov/pubmed/30002816 http://dx.doi.org/10.12688/f1000research.13792.1 |
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author | van der Ven, Jelle P. G. van den Bosch, Eva Bogers, Ad J.C.C. Helbing, Willem A. |
author_facet | van der Ven, Jelle P. G. van den Bosch, Eva Bogers, Ad J.C.C. Helbing, Willem A. |
author_sort | van der Ven, Jelle P. G. |
collection | PubMed |
description | In patients with a functionally univentricular heart, the Fontan strategy achieves separation of the systemic and pulmonary circulation and reduction of ventricular volume overload. Contemporary modifications of surgical techniques have significantly improved survival. However, the resulting Fontan physiology is associated with high morbidity. In this review, we discuss the state of the art of the Fontan strategy by assessing survival and risk factors for mortality. Complications of the Fontan circulation, such as cardiac arrhythmia, thromboembolism, and protein-losing enteropathy, are discussed. Common surgical and catheter-based interventions following Fontan completion are outlined. We describe functional status measurements such as quality of life and developmental outcomes in the contemporary Fontan patient. The current role of drug therapy in the Fontan patient is explored. Furthermore, we assess the current use and outcomes of mechanical circulatory support in the Fontan circulation and novel surgical innovations. Despite large improvements in outcomes for contemporary Fontan patients, a large burden of disease exists in this patient population. Continued efforts to improve outcomes are warranted. Several remaining challenges in the Fontan field are outlined. |
format | Online Article Text |
id | pubmed-6024235 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | F1000 Research Limited |
record_format | MEDLINE/PubMed |
spelling | pubmed-60242352018-07-11 State of the art of the Fontan strategy for treatment of univentricular heart disease van der Ven, Jelle P. G. van den Bosch, Eva Bogers, Ad J.C.C. Helbing, Willem A. F1000Res Review In patients with a functionally univentricular heart, the Fontan strategy achieves separation of the systemic and pulmonary circulation and reduction of ventricular volume overload. Contemporary modifications of surgical techniques have significantly improved survival. However, the resulting Fontan physiology is associated with high morbidity. In this review, we discuss the state of the art of the Fontan strategy by assessing survival and risk factors for mortality. Complications of the Fontan circulation, such as cardiac arrhythmia, thromboembolism, and protein-losing enteropathy, are discussed. Common surgical and catheter-based interventions following Fontan completion are outlined. We describe functional status measurements such as quality of life and developmental outcomes in the contemporary Fontan patient. The current role of drug therapy in the Fontan patient is explored. Furthermore, we assess the current use and outcomes of mechanical circulatory support in the Fontan circulation and novel surgical innovations. Despite large improvements in outcomes for contemporary Fontan patients, a large burden of disease exists in this patient population. Continued efforts to improve outcomes are warranted. Several remaining challenges in the Fontan field are outlined. F1000 Research Limited 2018-06-27 /pmc/articles/PMC6024235/ /pubmed/30002816 http://dx.doi.org/10.12688/f1000research.13792.1 Text en Copyright: © 2018 van der Ven JPG et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review van der Ven, Jelle P. G. van den Bosch, Eva Bogers, Ad J.C.C. Helbing, Willem A. State of the art of the Fontan strategy for treatment of univentricular heart disease |
title | State of the art of the Fontan strategy for treatment of univentricular heart disease |
title_full | State of the art of the Fontan strategy for treatment of univentricular heart disease |
title_fullStr | State of the art of the Fontan strategy for treatment of univentricular heart disease |
title_full_unstemmed | State of the art of the Fontan strategy for treatment of univentricular heart disease |
title_short | State of the art of the Fontan strategy for treatment of univentricular heart disease |
title_sort | state of the art of the fontan strategy for treatment of univentricular heart disease |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024235/ https://www.ncbi.nlm.nih.gov/pubmed/30002816 http://dx.doi.org/10.12688/f1000research.13792.1 |
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