Indiana University School of Medicine, Krannert Institute of Cardiology, IN.
University of Arizona School of Medicine, Phoenix, AZ.
Prog Cardiovasc Dis. 2018 Sep-Oct;61(3-4):365-376. doi: 10.1016/j.pcad.2018.09.005. Epub 2018 Sep 17.
In 1971, Fontan and Baudet described a surgical technique for successful palliation of patients with tricuspid atresia. Subsequently, this technique has been applied to treat most forms of functional single ventricles and has become the current standard of care for long-term palliation of all patients with single ventricle congenital heart disease. Since 1971, the Fontan procedure has undergone several variations. These patients require lifelong management including a thorough knowledge of their anatomic substrate, hemodynamic status, management of rhythm and ventricular function along with multi organ evaluation. As these patients enter middle age, there is increasing awareness regarding the long-term complications and mortality. This review highlights the long-term outcomes of the Fontan procedure and management of late sequelae.
1971 年,Fontan 和 Baudet 描述了一种治疗三尖瓣闭锁患者的成功姑息手术技术。随后,该技术被应用于治疗大多数功能性单心室,并成为所有单心室先天性心脏病患者长期姑息治疗的当前标准。自 1971 年以来,Fontan 手术经历了几次变化。这些患者需要终身管理,包括对其解剖学基础、血流动力学状态、节律和心室功能管理以及多器官评估的透彻了解。随着这些患者进入中年,人们越来越意识到长期并发症和死亡率。本综述强调了 Fontan 手术的长期结果和晚期后遗症的管理。