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This book provides a concise, practically applicable guide to the management of patients born with a univentricular heart defect. It describes the anatomy and epidemiology of the univentricular heart, while guidance is provided on how to manage both fetal and neonatal patients with this defect, as well as those in later childhood and adulthood. The utilization of the Fontan operation for patients with a univentricular heart is described in detail. Management of early and late Fontan failure is also discussed, and the pregnant patient is also described, enabling the reader to develop a deep understanding of how to manage these patients in their daily practice.
Univentricular Congenital Heart Defects: Practical Manual for Patient Management comprehensively reviews the management of univentricular heart defects and the use of Fontan-type surgery. It is a valuable resource for the experienced practitioner seeking a manual on the latest available techniques and for trainees who want to develop a thorough understanding of how to manage patients with these congenital heart defects.
Pages i-x
Pages 1-6
Front Matter
Pages 7-7
The Anatomical Substrates of the Univentricular Heart
Pages 9-30
Epidemiology of Univentricular Hearts
Pages 31-33
Front Matter
Pages 35-35
Prenatal Diagnosis of the Functionally Univentricular Heart
Pages 37-49
Postnatal Management and Pre-Operative Assessment of the Univentricular Patient
Pages 51-58
Imaging to Aid Decision Making in the Neonate
Pages 59-67
Univentricular Heart: Decision Making in the Management of the Neonate
Pages 69-79
Catheter Interventions in the Initial Palliation of Univentricular Hearts
Pages 81-86
Comfort Care in Patients with a Single Ventricle
Pages 87-91
Front Matter
Pages 93-93
History of the Fontan Surgical Procedure
Pages 95-97
Early Modifications of Fontan Surgery and Evolution of the Total Cavo-Pulmonary Connection (TCPC)
Pages 99-104
Staged Approach to Total Cavo-Pulmonary Connection
Pages 105-115
Classical Norwood Stage I and Modifications
Pages 117-122
Hybrid Strategies for Hypoplastic Left Heart Syndrome and Comprehensive Stage II Repair
Pages 123-127
Front Matter
Pages 129-129
Determinants of Cardiac Output and Exercise Tolerance in the Fontan Circulation
Pages 131-139
Front Matter
Pages 141-141
Neuro-developmental Outcomes of Fontan Patients
Pages 143-149
Follow-Up in Childhood of Fontan Patients: Quality of Life
Pages 151-160
Anticoagulation Strategies in the Single Ventricle
Pages 161-168
Electrophysiology Considerations After the Fontan Operation
Pages 169-176
Managing the Pulmonary Circulation
Pages 177-184
Fontan Failure in Children and Cardiac Transplantation
Pages 185-194
Front Matter
Pages 195-195
Pages 197-202
Front Matter
Pages 203-203
Considerations When Developing a Multidisciplinary Adult Fontan Clinic
Pages 205-211
Echocardiography and the Adult Fontan Patient
Pages 213-220
Cardiac MRI Imaging in the Fontan Patient
Pages 221-229
CT in Patients with Univentricular Hearts and a Fontan Circulation
Pages 231-237
Physiological Testing and Basics of Cardiac Catheterisation in Fontan Patients
Pages 239-251
Fontan Patients: Psychological Support in Adult Life
Pages 253-257
Pregnancy with an Univentricular Heart
Pages 259-271
Factors Impacting on the Late Outcome of the Fontan Circulation
Pages 273-280
Front Matter
Pages 281-281
Electrophysiology Considerations and Management of Arrhythmias After the Fontan Operation
Pages 283-293
A Multi-system Disorder: Extracardiac Complications
Pages 295-305
Front Matter
Pages 307-307
The Failing Adult Fontan Patient
Pages 309-326
Catheter-Based Interventions in Adult Life for the Failing Adult Fontan Patient
Pages 327-336
Surgical Interventions in Adult Fontan and Transplantation
Pages 337-345
Palliative Care Strategies in Adult Patients
Pages 347-351
Role of Mechanical Support for Failing Single Ventricle
Pages 353-356
Pathological Aspects of Post-Fontan Procedures
Pages 357-365
Pages 367-370
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