Learning Cardiology

Q. True regarding Fontan surgery? A. Bidirectional glenn shunt is usually done within 1 week of birth B. PA banding may be required in patients with significant pulmonary stenosis prior to glenn surgery C. Fenestration decreases post-op pleural effusion D. Peri-operative mortality is around 20% Answer: C. Fenestration decreased post-op pleural effusion Explanation: Fontan surgery is type of single ventricular repair required for some complex congenital heart diseases. It is a multistaged procedure. Also known as Total cavopulmonary connection (TCPC). It separates systemic and pulmonary circulation. 1 st stage procedure is done to normalize pulmonary blood flow (BT shunt in case of decreased pulmonary blood flow situations like PS and PA band in case of increased pulmonary blood flow situations). 2 nd stage is called bidirectional glenn shunt (BDG) or Hemifontan which is done at the age of 4-6 months and final stage is completion of Fontan Advantages:

Q. What is false regarding Fontan circuit? A. Fenestration improves cardiac output and reduces congestion B. Fenestration decreases systemic saturation C. Plastic bronchitis is rare but known complication D. Protein losing enteropathy does not improve after cardiac transplantation Answer: D. Protein losing enteropathy does not improve after cardiac transplantation Explanation:  Fontan procedure

Q. Which of the following is false about Fontan surgery? A. Systemic and pulmonary circulation are separated B. It is a type of univentricular repair C. It is done when PVRI is more than 6 woods units/m 2 D. Ten years survival is 80-85% Answer: C. It is done when PVRI is more than 6 woods units/m2 Explanation:  Fontan procedure