Fontan explained

The third step in Hannah’s heart surgery plan is what’s called a Fontan procedure. The Heart Centre at Westmead, who Hannah is looked after by, explain it like this…

“The heart normally has two sides, each with a collecting chamber (atrium) and pumping chamber (ventricle). The right side of the heart collects blue (low oxygen) blood returning from the body. This blood is pumped to the lungs to collect oxygen. The left side of the heart collects pink (high oxygen) blood returning to the heart from the lungs and pumps it to the body.

In some hearts, one of the two ventricles may be underdeveloped. In this case the ventricle is considered to be functionally single (and usually receives a mixture of pink and blue blood). In general it is not possible to replace or rebuild an underdeveloped ventricle, so management is focused on making the best use of the parts of the heart that are there. The way this is done when the underdeveloped ventricle cannot be used as a pump is to create a ‘Fontan Circulation’, named after the person who devised the first version of the operations designed to achieve this.

The objective of a Fontan Circulation is to direct all the blue blood straight to the lungs, without going through the heart. The heart chambers (and single ventricle) are used to pump blood returning mainly from the lungs to the body. Once the Fontan Circulation is completed it allows close to normal levels of oxygen in the body to be achieved, improving well-being and considerably improving protection against certain complications such as stroke.”

It involves putting a goretex tube in to redirect her circulation like this…

Normal heart

For Hannah, this will be the most efficient way for the side of the heart that she has (the left) to function. It should give her back usual energy levels, and the best prognosis at living a long life. It’s not an easy operation, it lasts more than 5 hours, but it is one with really good outcomes and they do it fairly regularly for a range of congenital heart conditions.

We have met with Hannah’s surgeon and are now waiting to see when the surgery goes ahead. We expect she’ll be in hospital for 2-3 weeks, first a couple of days in ICU and then time on the ward. One of the common after affects of this open heart surgery is fluid retention around the lungs and abdomen, which can influence how long it takes kids to recover.

From chatting to our surgeon, this is a harder surgery to do and recover from than the two Hannah has had already. But she is a good candidate for it, generally healthy and her recoveries for the last two have been smooth which all bodes well.

In all this we are keeping a realistic expectation that it could be delayed (due to no ICU bed or another child deteriorating faster than Hannah). Thanks for continuing to pray and support us during the waiting!

You can read more about the Fontan here or here.

Please pray for…

  • Her surgeon, cardiologist and cardiac care team who are overseeing the surgery, for wisdom and energy for them in these long complex operations.
  • That we would take our anxiety to God in prayer, knowing he is in control and his timing is right.
  • For wisdom loving Hannah and helping her understand and process what’s going on and why, especially as she recovers.

Trust in him at all times, you people; pour out your hearts to him, for God is our refuge. – Psalm 62:8


One thought on “Fontan explained

  1. Sara,
    I was only thinking of you all this am.
    Your clear description of this procedure gives us greater understanding.

    We look forward to hearing that you have an “eager little beaver” who can’t wait to get home .

    Our very best wishes & as mentioned previously ,if I can be of help please don’t hesitate to ask.


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