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The Heart Center at Nationwide
Children's is dedicated to the unique
needs of single ventricle patients such
as those with hypoplastic left heart
syndrome. If your child had a hybrid
stage two or comparable stage two
procedure for this condition, he or she
will receive a third procedure called
the Fontan procedure. The goal of the
stage three Fontan procedure is to allow
passive blood flow from the lower body
to the lungs. This further reduces the
workload of the single ventricle and
improves oxygen levels. The procedure is
usually performed at two to five years of age
or when the patient outgrows the
comprehensive stage two procedure. If your
child had the hybrid stage two procedure, three
main changes were made with that
procedure. The superior vena cava was
attached to the right pulmonary artery.
An enlarged opening was created between
the right and left atrium and a new
larger aorta was created. These changes
create less work for the single
ventricle to pump blood to the body. The
stage three or Fontan procedure is an open
heart surgery so your child will be
placed on a heart-lung bypass machine.
To begin, the surgeon will make an
incision in the chest over the previous
incision. Once the heart is reached, the
surgeon will separate the inferior vena
cava and hepatic veins from the heart.
Next a tube graft will be attached to
the inferior vena cava to make it longer.
Then the graft will be attached to the
underside of the right pulmonary artery.
The connection is called an extra
cardiac Fontan procedure. This new
connection allows oxygen poor blood from
the lower body to get to the lungs
without passing through the heart first.
Once the stage three or Fontan surgery is
complete most of the oxygen poor blood
will bypass the heart. This will improve
your child's oxygen saturation and
decrease the work the single ventricle
has to do. Our single ventricle team at
Nationwide Children's is dedicated to
supporting your child. We are available
to answer all of your questions at any
time at (614) 722-2530
and at Nationwidechildrens.org/heart

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