The Fontan procedure, a complex, multi-stage surgery, has dramatically improved outcomes for children born with single-ventricle heart defects, offering a path to improved quality of life previously unavailable. While not a cure, the procedure reroutes blood flow to allow for improved oxygenation and circulation. A recent discussion with leading Spanish cardiologists and a hepatologist explored the long-term challenges facing patients who have undergone this life-altering surgery,and the evolving clinical strategies for managing them.
Published: January 3, 2026 |
The Fontan circulation has fundamentally changed how doctors treat children born with congenital heart defects who have only one functioning ventricle. This complex procedure offers a lifeline to these patients, but also presents long-term health challenges that require careful monitoring.
Developed in the 1960s and 70s by doctors Fontan and Kreutzer, this revolutionary technique involves a staged approach to separate the pulmonary and systemic circulations. The single ventricle is dedicated to systemic circulation, while pulmonary circulation becomes a passive circuit. This strategy reduces the strain on the ventricle and prevents both cyanosis and excessive blood flow to the lungs. However, the unique physiology of the Fontan circulation also carries its own set of potential complications.
What are those complications, and what clinical challenges do they pose for patient care? A recent discussion featuring cardiologists Pastora Gallego and Raquel Prieto, and hepatologist Luis Téllez, explored these critical questions.
Participants:
University Hospital 12 de Octubre, Madrid
Pastora Gallego GarcÃa de VinuesaCongenital Heart Disease and Pediatric Cardiology. Virgen del RocÃo University Hospital, Seville
Luis Téllez VillajosHepatology. Ramón y Cajal University Hospital, Madrid
Raquel Prieto ArévaloCardiology. Gregorio Marañón General University Hospital, Madrid
