Abstract
Since Fontan in 1971 described a physiological correction for tricuspid atresia few successful
operations have been reported. Two patients corrected 20 and 10 months ago at the
Brompton Hospital are presented. These patients exhibit many of the problems in the
management of tricuspid atresia. The first aged 20 having previously undergone three
palliative operations, and therefore, presented a number of operative problems. The
second, aged 8, had had no previous surgical treatment and was found at operation
to have a partial atrial ventricular canal. The operative procedures, and the post
operative course are described, the criteria for selection of patients for the Fontan
operation are discussed as are the possible long term hazards of homograft failure,
atrial dysrhythmias and hepatic dysfunction. The successful outcome of these two patients
suggest that palliative surgery in infancy should allow for this form of correction
in later life.
