Staged Single Ventricle Reconstruction

Fontan Procedure

The final staged reconstructive surgery, the Fontan Procedure, occurs when your child is between 18 months to three years old. This operation is the final step in reconnecting the heart’s circulation as surgeons return the inferior vena cava – the large vein that moves deoxygenated blood from the lower body to the heart – from the heart to the pulmonary artery. This allows all deoxygenated blood to travel directly to the lungs. Sometimes a small hole is added near the right wall to act as a relief valve while the lungs get used to the new blood flow from the lower body. Small holes may close on their own; larger ones can be closed later using cardiac catherization. Your child may return home a week or two after surgery.

Why Choose Riley at IU Health for Your Child's Staged Reconstruction Surgery?

Your child receives high-quality care throughout these staged reconstruction surgeries at Riley at IU health. We are one of only a few children’s hospitals nationwide to achieve a three-star rating from the Society of Thoracic Surgeons (STS) for our outcomes on these procedures. Our outcomes are better than the national average of children’s hospitals in the STS database – highlighting our commitment to providing the best care for your child. Learn more about our volumes & outcomes.

How Will My Child be Monitored Throughout Staged Reconstructive Surgeries?

Our Interstage Home Monitoring Program is a convenient and accessible way for you to monitor your child at home and remain in close contact with your child’s care team to ensure any issues are addressed quickly.

In this program:

• You take home a scale and pulse oximeter to measure your child’s progress
• You receive an iPad with helpful at-home monitoring information that provides updates to your child’s care team in real time
• An on-call nurse practitioner is available to answer any questions and provide reliable medical or problem-solving advice for both urgent and non-emergent issues
• Our Parent Mentor Program pairs experienced, trained parents with families whose children are newly diagnosed with single ventricle conditions to offer parent-to-parent support

Since this program launched in 2010, the survival rate between the first and second single-ventricle heart surgeries has increased from 82% to 95%, with fewer children experiencing growth failure and more parents taking advantage of therapies to reduce developmental delays. Our successful program has been replicated at children’s hospitals throughout the country.

Key Points to Remember

• These surgeries affect your child’s circulation system and so your child may appear slightly blue after the first two surgeries, especially when he or she cries. Talk with your doctor if you’re concerned about your child’s complexion.
• Your child will be monitored throughout these three staged surgeries to reduce the chance of risks related to any of the procedures.
• Your doctor will perform a number of diagnostic tests between surgeries and throughout childhood to ensure your child is progressing appropriately.