Surgical repair of cyanotic cardiac defects in young adults. The Fontan procedure and use of the extracardiac valved conduit.

Improvement in the health status of young adults with complex cyanotic congenital cardiac defects has been realized with recent advances in cardiovascular surgical techniques. The Fontan procedure and its modifications have allowed physiologic correction of tricuspid atresia by separating the pulmonary and systemic circulations and creating a direct connection from right atrium to pulmonary artery. The extracardiac valved conduit has been successfully used in the repair of pulmonary atresia with ventricular septal defect, and the triad of transposition of the great vessels, ventricular septal defect, and pulmonary stenosis. Nursing implications for the care of these patients in the postoperative period and their long-term management has been addressed. Advances in surgical techniques have brought these anomalies into the realm of surgical repair and have increased the life expectancy of these patients, and thus more patients with these cardiac defects will be seen in adult cardiology settings.