A case of single ventricle with pulmonary stenosis treated successfully by a modified Fontan procedure
Atsumi, N.; Suma, K.; Takeuchi, Y.; Shiroma, K.; Inoue, K.; Koyama, Y.
Nihon Kyobu Geka Gakkai 34(3): 400-405
1986
ISSN/ISBN: 0369-4739 PMID: 3722944 Document Number: 285374
A modified Fontan procedure was successfully performed on a 19-year-old male with single ventricle with pulmonary stenosis (Type IIC). The right atrioventricular valve was closed with a pericardial patch, and the posterior wall of the right atrium was anastomosed to the pulmonary artery directly. It is very important for successful Fontan procedure to minimize resistance in the vena cavae-pulmonary arterial region by making a largest possible atriopulmonary anastomosis. In our case a right atrial incision was made parallel and close to the atrial septum, extending from SVC to the right atrioventricular groove, and a pulmonary arterial incision was extended from the trunk to the point of the right pulmonary artery crossing SVC. Postoperative atriography demonstrated the widely patent orifice of the atriopulmonary anastomosis and pressure study indicated no pressure gradient between the right atrium and the pulmonary artery. Exercise ability was very much improved after the operation and the patient tolerated up to stage III of treadmill test in Bruce protocol.