The concept of Fontan circulation was first clinically introduced in 1971. Since that
time, many technical modifications have been advocated. Among them, the concept of
total cavopulmonary connection, introduced in the late 80's [1], has experienced widespread use over the past 10 years. In this procedure, a bidirectional
superior cavopulmonary anastomosis is performed while the inferior caval blood flow
is directed towards the pulmonary arteries through an intraatrial composite tunnel.
More recently, an extracardiac conduit to divert inferior vena cava flow to the pulmonary
arteries has been advocated [2]
[3]
[4]. The respective merits of these two approaches remain to be determined.
Functioning single ventricle - Fontan circulation