**5. Results of Fontan operation**

Immediate and follow-up results of both older and current types of Fontan will be reviewed in this section.

**139**

**5.1 Immediate results**

**Figure 10.**

**Figure 9.**

care setting was prolonged.

The results of original Fontan [1, 2] and its earlier modifications, namely, RA-to-PA or RA-to-RV anastomosis either directly or via valved or non-valved conduits, revealed high initial mortality rates. The initial mortality rates ranged from 10 to 26% [9, 10, 71, 72]. Furthermore, the postoperative stay in the intensive

*(A) A selected cineangiographic frame showing the Fontan conduit in lateral view, demonstrating a residual shunt (RS) at the superior aspect of the conduit (Cond). (B) The RS was occluded with an Amplatzer septal* 

*occluder device (AD); the residual shunt is no longer seen. TEE, transesophageal echo probe.*

*(A) Selected cine frame from a Fontan conduit cineangiogram in anteroposterior view, demonstrating tubular fenestration (Tu fen) with opacification of the left atrium (LA). (B) The Tu fen is closed with an Amplatzer vascular plug (AVP). (C) A follow-up conduit cineangiogram after AVP implantation, showing complete* 

The initial mortality following staged, total cavopulmonary connection has decreased remarkably [73–78]. Patients who had total cavopulmonary connection

*Fontan Operation: A Comprehensive Review DOI: http://dx.doi.org/10.5772/intechopen.92591*

*occlusion of the Tu fen. TEE, transesophageal probe.*

### **Figure 9.**

*Advances in Complex Valvular Disease*

**138**

**Figure 8.**

**Figure 7.**

**5. Results of Fontan operation**

be reviewed in this section.

*(Stage IIIB). Reproduced from [30].*

Immediate and follow-up results of both older and current types of Fontan will

*Stage IIIB. (a) Selected frames from cineangiograms in lateral view of the same patient illustrated in* **Figure 5** *showing Stage IIIA of the Fontan operation in which the inferior vena caval (IVC) flow is diverted into the pulmonary arteries by a non-valve conduit (Cond). The fenestration (fen) is shown by the arrow in (a). (b) Closure of the fenestration with an Amplatzer septal occluder device (D) is shown with an arrow in (b).* 

*Stage IIIB. (a) Selected frames from cineangiograms in anteroposterior projection illustrating Stage IIIA of the Fontan operation in which the inferior vena caval (IVC) flow is diverted into the pulmonary arteries by a non-valve conduit (Cond). The fenestration (fen) is shown by the arrow in (a). (b) Closure of the fenestration with an Amplatzer septal occluder device (D) is shown with an arrow in (b). HV, hepatic veins; LPA, left* 

*pulmonary artery; RPA, right pulmonary artery (Reproduced from [30]).*

*(A) Selected cine frame from a Fontan conduit cineangiogram in anteroposterior view, demonstrating tubular fenestration (Tu fen) with opacification of the left atrium (LA). (B) The Tu fen is closed with an Amplatzer vascular plug (AVP). (C) A follow-up conduit cineangiogram after AVP implantation, showing complete occlusion of the Tu fen. TEE, transesophageal probe.*

### **Figure 10.**

*(A) A selected cineangiographic frame showing the Fontan conduit in lateral view, demonstrating a residual shunt (RS) at the superior aspect of the conduit (Cond). (B) The RS was occluded with an Amplatzer septal occluder device (AD); the residual shunt is no longer seen. TEE, transesophageal echo probe.*
