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World J Cardiol. Aug 26, 2014; 6(8): 861-864
Published online Aug 26, 2014. doi: 10.4330/wjc.v6.i8.861
Long term negative pressure ventilation: Rescue for the failing fontan?
Shriprasad R Deshpande, Kevin O Maher
Shriprasad R Deshpande, Kevin O Maher, Division of Pediatric Cardiology, Emory University, Children’s Healthcare of Atlanta, Atlanta, GA 30322, United States
Author contributions: Both authors contributed to this work.
Correspondence to: Shriprasad R Deshpande, MD, MS, Division of Pediatric Cardiology, Emory University, Children’s Healthcare of Atlanta, 1405 Clifton Rd NE, Atlanta, GA 30322, United States. deshpandes@kidsheart.com
Telephone: +1-404-6947739 Fax: +1-770-4889480
Received: March 25, 2014
Revised: May 20, 2014
Accepted: June 18, 2014
Published online: August 26, 2014
Processing time: 176 Days and 14.1 Hours
Core Tip

Core tip: In the current surgical era for congenital heart disease, palliation of single ventricle patients has become standard of care. However, pathophysiologic failure after the thrid stage of palliation (Fontan) is commonplace, with very few therapeutic options. Failing Fontan physiology is a management challenge. Herein, we review the pathophysiology of failing Fontan, current therapies and propose a novel way of treating the failing Fontan by utilizing negative pressure ventilation to reverse some of the maladapative changes. This is a hypothesis paper. We think, the ideas central to the manuscript are worth bringing out for intellectual discussion and wider testing.