Can Fontan patients have babies?
The numbers of Fontan women who have gone through pregnancy are small. Successful pregnancy is achievable, although there is an increased risk for maternal and fetal complications. Current data suggest that fetal morbidity is significantly higher than maternal morbidity.
Does pregnancy impact subsequent health outcomes in the maternal Fontan circulation?
Background: Pregnancy in women with a Fontan circulation is understood to have a significantly increased risk of maternal morbidity and mortality. Potential longer-term effects on health outcomes remain unknown.
What happens when a Fontan fails?
Late Fontan failure may present insidiously over years. It is a failure of medical management to interpret the absence of overt symptoms or ascites as evidence of optimal haemodynamic status in the functionally univentricular circulation.
What does the Fontan procedure correct?
The Fontan procedure refers to any surgical procedure that leads to systemic flow of venous blood to the lungs without passing through a ventricle. In 1971, Fontan and Baudet (1) described a surgical procedure for repair of tricuspid atresia that built on experimental and clinical research from the 1940s.
Can someone with HLHS get pregnant?
Prior to development of staged reconstruction (i.e., Norwood procedure), HLHS was almost universally fatal within months of birth. Early survivors of the Norwood procedure are now reaching reproductive age. We report successful pregnancies in two such women.
How long can you live with a Fontan?
Conclusions: Over 80% of patients who survive Fontan surgery will be alive at 20 years. Developing late sequelae including protein losing enteropathy, ventricular dysfunction or requiring a pacemaker predict a higher risk of late death.
Who gets a Fontan procedure?
The Fontan procedure is a type of open-heart surgery. Children who need this surgery usually have it when they’re 18–36 months old.
Can you see HLHS on ultrasound?
[6] HLHS can be detected on prenatal sonography between 18 and 22 weeks of gestation with a 4-chamber view of the fetal heart. HLHS carries a poor prognosis with a survival rate reported of 40%–55% after prenatal diagnosis.
What happens after Fontan?
After the Fontan procedure, the blood from the lower body goes directly to the lungs. The blood with high oxygen goes into the heart. This way the single ventricle: only pumps blood to the body.
How old is the oldest Fontan patient?
The oldest survivor after the Fontan operation was 67 years of age (Fontan at age 39 years). Of the 723 follow-up questionnaires mailed out, 305 (42%) were returned.
Is pregnancy safe for women with a well-functioning Fontan circulation?
Retrospective review of the published literature in pregnant women with a relatively well-functioning Fontan circulation suggests that although pregnancy is relatively well tolerated, it remains a high risk undertaking, and the potential morbidities are both high and may be life threatening.
Is postpartum hemorrhage a complication of pregnancy in women with Fontan circulation?
Postpartum hemorrhage seems to be the most common obstetric complication. Large-scale data sets are needed to confirm these early observations and address the late sequelae of pregnancy in women with a Fontan circulation. Fontan palliation is a life-saving surgical procedure for patients with complex congenital heart disease.
Does Fontan palliation affect pregnancy outcomes?
[…] Pregnancy in women with Fontan physiology poses a significant management challenge and is deemed high risk. The aim of this study is to describe short and long-term pregnancy outcomes in women who have undergone Fontan palliation and propose a novel risk-stratification model specific to women with a Fontan heart.
Is ventricular function in women with a Fontan circulation accurately assessed?
However, there is likely to be inherent inter and intra observer variability in the reported ventricular function which may limit accurate assessment. Women with a Fontan circulation who wish to become pregnant are at high risk of miscarriage, fetal complications and major obstetric and cardiovascular maternal morbidity.