Rescuing the Late Failing Fontan: Focus on Surgical Treatment of Dysrhythmias

Freedom from cardiac death or transplant for patients undergoing Fontan conversion with arrhythmia surgery is 84% at 10 years. The effects of atrial arrhythmia operations are durable in most patients. There is increasing evidence that earlier referral of patients with an atriopulmonary Fontan for Fontan conversion will improve long-term results. Fontan conversion should be performed at centers with the institutional expertise to care for these complex patients. Note that this is an eroding patient population. The time to act may be now.