The Fontan palliation was introduced in 1968 for congenital heart defects with a single dominant ventricle. Although considerable technical improvements have meant that this procedure can be applied to a wide range of patients, the Fontan circulation has intrinsic limitations. Professors de Leval and Deanfield consider the past four decades of Fontan palliation and describe how developments have moved practice closer to the 'perfect' Fontan. Future challenges and possible solutions are also discussed.
- Marc R. de Leval
- John E. Deanfield
