Hemi-Fontan Operation
The second-stage operation in single ventricle palliation, creating a direct connection between the superior vena cava and pulmonary arteries while maintaining antegrade pulmonary blood flow.
Full Definition
The hemi-Fontan operation is an intermediate procedure in the staged surgical management of single ventricle congenital heart defects, typically performed between 4-8 months of age. This operation creates a direct connection between the superior vena cava and the right pulmonary artery while maintaining some degree of antegrade pulmonary blood flow from the ventricle. Unlike the bidirectional Glenn shunt, the hemi-Fontan preserves the possibility of augmenting pulmonary blood flow while unloading the single ventricle. The procedure involves anastomosing the superior vena cava to the pulmonary arteries and placing a patch to separate systemic and pulmonary venous return at the atrial level. This sets the stage for eventual Fontan completion.
Usage
Usage note: Distinguish from bidirectional Glenn shunt, which completely disconnects antegrade pulmonary flow.
In Context
- "The patient underwent hemi-Fontan operation with excellent early postoperative hemodynamics and preserved ventricular function." — Operative report
- "Cardiac catheterization six months after hemi-Fontan demonstrated low pulmonary vascular resistance suitable for Fontan completion." — Pre-Fontan evaluation