Aster Medcity performs Kerala's first non-surgical Fontan procedure on children with single-ventricle heart

KOCHI: Aster Medcity successfully performed the first-ever Transcatheter Fontan completions in Kerala, marking a significant advancement in pediatric cardiology. These procedures were performed on two young children who had not undergone prior surgical preparation for this stage, offering them a less invasive path to improved health.

The Fontan completion is a crucial final step for children born with a complex heart condition called single ventricle (or univentricular) physiology. This condition means they have only one effective pumping chamber in their heart. Traditionally, this involves a major open-heart surgery to connect the inferior vena cava (a large vein carrying blood from the lower body) directly to the pulmonary artery (which carries blood to the lungs).

Among the first patients was a five-year-old girl from Idukki, who was born with pulmonary atresia and an intact ventricular septum. She had previously undergone a bidirectional Glenn shunt in infancy. Due to her family's adherence to the Jehovah's Witness community, which prohibits blood transfusions, she had been refused redo surgery elsewhere, given the potential for massive bleeding during traditional open-heart surgery. The procedure, meticulously planned and executed, involved connecting the inferior vena cava to the pulmonary artery with a covered stent. She was discharged on day five and is reportedly doing remarkably well two months post-procedure.

Another patient to benefit from this pioneering procedure was a four-and-a-half-year-old boy from Ernakulam District. He had been diagnosed with double-inlet left ventricle and had already undergone two palliative surgeries. His parents were understandably keen to avoid a third open-heart surgery. After a detailed analysis of CT images, a Transcatheter Fontan was performed. A covered stent was expertly placed from the inferior vena cava into the pulmonary artery, completing the Fontan circulation. The child experienced a quick recovery post-procedure, with no complications.

This innovative approach offers hope for many families seeking less invasive options for their children with complex congenital heart disease, and we are immensely proud to offer this less invasive and highly effective treatment option in the state for the first time,” said Dr Edwin Francis, Director & Senior Consultant - Paediatric Cardiology, Aster Medcity, Kochi.

Both procedures involved placing a covered stent from the inferior vena cava into the pulmonary artery, effectively achieving the Fontan circulation without major incisions.