The Fontan Clinic is a dedicated clinic for evaluation and management of patients who have undergone or are scheduled for total cavopulmonary connection (TCPC), commonly referred to as the Fontan surgery, the destination surgery of a series of surgeries for complex univentricular congenital heart diseases.
The Fontan Clinic at SCTIMST is the first dedicated program in the country that offers holistic, individualized care for Fontan patients of all ages. The Fontan Clinic at SCTIMST primarily caters to registered patients at SCTIMST. We also welcome all Fontan patients from across the country and abroad to attend our clinic for follow up, or for a second opinion. We also offer second opinion to other care providers.
The Fontan pathway was a milestone in the palliation of children born with complex univentricular heart diseases 90% of who would not have survived beyond their first birthday without intervention. While the procedure permits longer survival of these patients, this circulation involves several compromises from normal human circulation and poses several challenges with increasing age after surgery. Since a normal two-pumped heart which supports the human circulation is not feasible for these patients, they are palliated into a phylogenetically lower single-pump circulation to meet the requirements of the body.
While the ideal Fontan circulation does very well for long, it is not unusual for other organ systems like the liver, kidney, lungs and the gut to present with issues with the newly fashioned circulation. Therefore, it is important for Fontan patients to be followed up regularly with a holistic approach.
The clinic aims at comprehensive rehabilitation and follow-up of children and adults who have undergone Fontan surgery. This includes implementation of protocol-based measures to improve quality of life of these patients by timely surveillance, evaluation and investigations.
The Fontan clinic is conducted by the Pediatric Cardiology division of the Department of Cardiology. The congenital heart surgery division of the department of cardiothoracic and vascular surgery works glove-in-hand with pediatric cardiology in the management of these patients. The core team of the Fontan clinic comprises Pediatric Cardiologists, Pediatric cardiac surgeons, physical medicine and rehabilitation, yoga trainer, counsellor and medicosocial workers. When appropriate, consultants from allied specialties – including pediatric and behavioural neurology, imaging sciences and interventional radiology, cardiac electrophysiology, cardiac anesthesia and pain medicine, gastroenterology, nephrology, gynecology, pulmonary medicine, vascular surgery – provide the comprehensive evaluation and management of these patients.
The Fontan clinic is conducted on Mondays in the forenoon at the Cardiology Specialty Clinics complex in Block B of the hospital wing. An appointment can be registered by contacting us at Phone: +91 – 471 – 2524533.
The institute has been managing single ventricle hearts for nearly four decades and has among the largest number of Fontan palliated patients in the country. The team understands the issues associated with Fontan circulation and offers comprehensive measures for rehabilitation. We have several completed and ongoing research in Fontan circulation.