術式の改良と周術期管理法の進歩でFontan手術の成績は大きく改善し，術後患者の多くが成人領域に達している近年，Fontan循環特有の遠隔期合併症の発生や心室機能障害，運動耐容能の低下などFontan術後患者のQOLを低下させる要因が明らかにされ大きな注目を集めている．多くの因子がFontan循環を破綻させる危険性を持っており，良好なFontan循環を維持するためには綿密な内科的治療の継続に加え，病態に応じた適切なカテーテル治療および外科的治療の再介入が必要である．
The surgical outcome of the Fontan operation has improved with refinements of the surgical technique and advances in perioperative management. As a large number of patients survive to adult after the surgery, the factors responsible for deterioration of patient quality of life have become important concerns. To maintain a sufficient Fontan circulation, catheterization or surgical re-intervention must be considered at the appropriate time together with meticulous follow-up and medical treatment.
Key words: Fontan; late outcome; complication; re-intervention; Fontan failure
© 2017 特定非営利活動法人日本小児循環器学会© 2017 Japanese Society of Pediatric Cardiology and Cardiac Surgery
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