Fontan procedure

The third and last of the staged congenital heart surgeries performed to treat hypoplastic left heart syndrome (HLHS) and other single ventricle heart defects is the Fontan cardiac procedure. It is usually performed between the ages of 18 months and three years.

What is the Fontan Procedure?

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During a Fontan surgery, congenital heart surgeons reroute the blood flow from the lower body to the lungs by connecting the inferior vena cava to the pulmonary artery. To accomplish this, surgeons will most often create a connecting channel, or tube, outside of the heart. Blood flow from the lower body now joins the connection made in the second procedure, the Glenn procedure, in which the blood flow from the upper body was rerouted to the lungs. Once the blood is oxygen-enriched in the lungs, the heart's single, right ventricle drives it out to the body again.

Since the Fontan procedure requires open heart surgery, your toddler will be on a heart-lung machine to temporarily take over blood circulation and breathing. The procedure will last about five hours. Fontan surgery recovery usually requires a two- or three-week hospital stay that will start in the cardiac intensive care unit (CICU). Learn more about postoperative care following surgeries for hypoplastic left heart syndrome.

Outstanding Fontan procedure outcomes

Children undergoing Fontan surgery are older and at less risk than when they were newborns facing open heart surgery, so survival rates are generally high – especially at Children's Wisconsin, where they exceed 99 percent. Our program consistently outperforms when it comes to congenital heart surgery outcomes for even the most complex types of heart disease, as evaluated by the Society of Thoracic Surgeons. Learn more about our heart surgery outcomes.

Note: Data is provided from the Society of Thoracic Surgeons (STS). New data is not available beyond June 2019, as STS is in the process of refining their reporting methodologies. Hospitals are also limited in providing updated data due to the demands of the COVID-19 pandemic.

Fontan Survivorship and Advanced Therapies Program

Our Fontan Survivorship Program was created specifically to care for children, adolescents, and adults with single ventricle heart disease. Although life expectancy and outcomes after the Fontan procedure have improved, some patients may develop health problems later in life. These “Fontan-associated” problems may impact not just the heart, but also other parts of the body such as the lungs, gastrointestinal system, liver, growth, and other aspects of the child’s health and development. Our Fontan Survivorship Program is staffed by a multidisciplinary team of experts trained to provide the best possible care for children and adults who have had the Fontan procedure. Learn more about our program.

Learn more about the two other open heart surgeries that are a part of HLHS treatment: the Norwood and Glenn procedures.