Cardiac Transplantation of the Fontan Patient with a Prior Norwood Procedure

摘要

Single-ventricle palliation starting with a Norwood procedure which culminates in a failed Fontan palliation poses certain unique operative challenges for cardiac transplantation. In this manuscript, we describe some of these challenges and our particular approach in management.Introduction:Several authors have reported the challenges and outcomes with transplantation of patients with failed Fontan palliation (FF).1-8 In this report, we focus on the transplant procedure for a patient with FF after staged palliation that began with a Norwood procedure (FFN). We agree with Konstantinov et al. that these procedures often entail unique considerations and challenges most often related to the reconstructed neo-aortic root, ascending aorta (AAo), aortic arch, and/or stented central pulmonary arteries (PA).8 While not exclusive to FFN, FFN patients also usually lack one or more peripheral vessel cannulation sites.