Fontan Procedure

Epidemiology

  • Pleural effusion occurs in almost all cases

Physiology

  • RV bypass (due to surgical anastomosis between PA and RA, SVC, or IVC created for tricuspid atresia or univentricular heart) -> possibly involves pleural fluid transudation from parietal pleura, decreased pleural lymphatic drainage, or lymphatic leakage into pleural space

Clinical Presentations

  • Pleural Effusion (see [[Pleural Effusion-Transudate]])
    • Bilateral (60%)/ may be large
    • May be a significant problem in many patients post-op

Treatment

  • Pleuroperitoneal shunt: indicated for large post-op effusions
  • Pleurodesis: may be required in some cases

References

  • xxx