Editor’s Pick: The Fontan Circulation

In our editor’s pick for this edition, Sathananthan et al. delve into the history and provide an overview of the Fontan operation, an innovative procedure first introduced in the 1970s to treat complex heart disease in children. Although a small minority face long-term negative physiological consequences from the procedure, Sathananthan and colleagues remark that, nonetheless, the procedure has had an overwhelmingly positive impact on the majority of patients, who have gone on to have a good quality of life. The authors stress the importance of early detection and management in instances of congenital heart disease as being key to long-term survival.

*Gnalini Sathananthan, Boris S. Lowe, Tim S. Hornung
Auckland City Hospital, Auckland, New Zealand
*Correspondence to gnalini20@gmail.com

Disclosure: The authors have declared no conflicts of interest.
Received: 10.03.16 Accepted: 02.08.16
Citation: EMJ Cardiol. 2016;4[1]:76-83.


The original Fontan procedure was first introduced in the 1970s. The concept behind this surgical technique was revolutionary. It has subsequently transformed the lives of children born with complex congenital heart disease which was once thought to be inoperable and resulted in early death. The procedure itself has had several modifications over the decades, with subsequent improvements in long-term outcomes for these patients. Fontan patients are now surviving well into adulthood and the majority are able to live wholesome fulfilling lives. There are, however, a small proportion who are faced with the negative long-term physiological effects of this unconventional circulation. Early detection and management of these patients is the key to their long-term survival.

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