Modifications of Fontan Operation
Inclusion of the tiny under-developed Right Ventricle in the repair
When the right ventricle is not too small, it may be included in the circulation with some benefit. In Bjork's modification of the Fontan procedure, a passage is created using pericardium, connecting the right atrium to the small right ventricle. As blood flows into it, the right ventricle grows in size. It will then help pump blood into the lungs, and avoid some of the disadvantages of a "classical" Fontan.
One and a half ventricle repair
This new operation attempts to combine the advantages of both the above strategies. A connection is made between the superior vena cava and right pulmonary artery, just as in a bidirectional Glenn shunt. But the pulmonary artery is not interrupted, thus allowing blood from the inferior vena cava also to enter the pulmonary artery. This blood is pumped partly by a small (about "one-half normal" sized) right ventricle, hence the name "one and a half ventricle repair".
To see some pictures of the Fontan operation, click here.