00:00 - Introduction
03:19 - The First Generation
06:52 - The Second Generation Lateral Tunnel Fontan {LTF} Procedure
10:46 - The Hemi-Fontan {HF} Operation
16:34 - Third Generation-The Extra-Cardiac Conduit Fontan Procedure (ECC)
22:51 - Fourth Generation - The Intra / Extra Cardiac Fontan (IECF)
27:16 - Concept of Fenestration
Up until the mid-1900's, tricuspid atresia - a birth defect of the tricuspid valve, was once categorized as a “death sentence.” The challenge of achieving positive health outcomes for affected patients was compounded by a hesitancy to operate on children. The main concern was safely administering anesthesia to young patients who were going through a strenuous operation that was often poorly tolerated. Despite these assumed limitations, Francis Fontan, a pediatric cardiothoracic surgeon at the Hospital of Tondu in Bordeaux, was able to redirect blood flow from the superior and inferior vena cava to the pulmonary arteries in 1971, which elucidated the process of advancing clinical practice in medicine. With the support of mentors and a firm belief in this new technique, Fontan pioneered his eponymous procedure and ultimately paved the way for modern cardiovascular surgical techniques that helped to prolong the life of those with single functioning ventricles. The aim of this study is to examine the genesis and the evolution of the Fontan procedure to elucidate the process of advancing clinical practice in medicine by utilizing personal interviews, Fontan's works, associated primary and secondary sources in the context of 20th century cardiothoracic surgery and innovations.
