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Fontan Procedure

Why Does a Baby Need the Fontan Procedure?

In hypoplastic left heart syndrome (HLHS), the left side of the heart doesn't grow as it should, making it smaller and weaker than normal. To survive, babies who are born with this rare heart defect need a series of three surgeries.

The left side of the heart can't be fixed. Instead, the surgeries rebuild parts of the heart and redirect the way blood flows around the body.

They are (in order):

  1. the Norwood Procedure
  2. the Glenn Procedure
  3. the Fontan Procedure

Babies get the Fontan Procedure when they're 18 months to 3 years of age.

What Is the Fontan Procedure?

The Fontan procedure is a type of open-heart surgery. The goal is to:

  • Make blood from the lower part of the body go directly to the lungs. This lets the blood pick up oxygen without having to pass through the heart.

In babies with hypoplastic left heart syndrome, low-oxygen blood from the lower part of the body mixes with high-oxygen blood. After the Fontan procedure, low-oxygen blood and high-oxygen blood no longer mix. This lets the heart deliver only high-oxygen blood to the body.

What Happens During the Fontan Procedure?

The Fontan procedure involves redirecting blood flow from the lower body to the lungs. In the Fontan procedure:

Blood from the lower body now goes to the pulmonary artery, and then to the lungs, without having to go to the heart. And, the right ventricle has become the main pump and can send blood just to the body.

What Happens After the Fontan Procedure?

Children who have the Fontan procedure usually spend 1 to 2 weeks in the hospital to recover. They get-around-the-clock care and monitoring. They also get medicines to help the heart and improve blood flow.

Sometimes, high blood pressure after surgery can't be helped with just medicine. If this happens, a fenestration might be needed. During a fenestration, doctors make a small hole in the heart between the left atrium and right atrium so blood can flow through. This helps ease blood pressure.

What Else Should I Know?

Many children thrive and do well after heart surgery. Go to all doctors visits and follow the care guidelines from your care team to help keep your child as healthy as possible.

Sometimes, the three heart surgeries may not totally fix all heart problems. In these cases, a child may need a heart transplant.

Many kids who have heart transplants go on to live normal, healthy lives. In the long term, they need to take medicines to help prevent complications and go to regular checkups.

Reviewed by: Kate M. Cronan, MD
Date reviewed: July 2018

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