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When they are bigger, you go back and do a staged Fontan procedure."
Therefore children with high pulmonary vascular resistance may not tolerate a Fontan procedure.
If the right ventricle is small and unable to act as a pump, doctors may perform another type of operation called the Fontan procedure.
There are three different types of Fontan procedure:
The Blalock-Taussig shunt may be used as the first step in the Fontan procedure.
The Fontan procedure is palliative, not curative.
Patients receiving the Fontan Procedure have an increased incidence of "Plastic Bronchitis."
This procedure is largely replaced by Bidirectional Glenn procedure (Fontan procedure).
The final procedure, the Fontan (Fontan procedure) completes the repair of the hypoplastic left heart.
After this first step (switching the right ventricle in functional position of the absent left ventricle) children generally proceed down the path to a Fontan procedure.
This is also the reason a Fontan procedure cannot be done immediately after birth; the pulmonary vascular resistance is high in utero and takes months to drop.
Later, surgical options include the Damus-Kaye-Stansel Procedure, the Fontan procedure, and the Norwood procedure.
The Fontan procedure, or Fontan/Kreutzer procedure, is a palliative surgical procedure used in children with complex congenital heart defects.
Therefore, when either they are large enough, and if the pressure in the pulmonary arteries is low enough, these children are referred for the Fontan procedure commonly after 2 years of life.
When the Fontan Procedure was first being done for children with HLHS, the only Fontan was the Lateral Tunnel Fontan.
Four case reports of hepatocellular carcinoma following the Fontan Procedure were reported by physicians at the Mayo Clinic in the New England Journal of Medicine (368;18 pp 1756-1757).
However, the hypoxia can worsen over time (because of the development of microscopic AVMs in the lungs that allow blood to pass through without being oxygenated), and therefore these children still may need a complete Fontan procedure in the end.
Currently, infants undergo either the staged reconstructive surgery (Norwood or Sano procedure within a few days of birth, Glenn or Hemi-Fontan procedure at 3 to 6 months of age, and the Fontan procedure at 1 1/2 to 5 years of age) or cardiac transplantation.