Fontan Procedure Cost in India

Fontan procedure is a life-changing surgical intervention designed for patients with congenital heart defects that result in single ventricle physiology. 

For many children born with complex heart conditions, this operation offers a pathway to improved health and quality of life. By redirecting blood flow and ensuring that oxygenated and deoxygenated blood do not mix, the procedure aims to enhance the heart’s efficiency. 

​While the road to surgery can be daunting for families, the Fontan procedure holds the promise of a brighter future, allowing many patients to lead more active and fulfilling lives as they grow.

Fontan procedure cost in India is more affordable when compared with our countries making it a desired destination for many patients. Furthermore, India has some of the best cardiac surgeons who are highly acknowledged for their skills and experience in treating patients. 

Fontan Procedure Cost in India

Many patients who have been diagnosed with congenital heart defects come to India to have Fontan surgery as the cost for the surgery is more reasonable and affordable compared to Western countries. The cost of Fontan procedure in India starts from INR 4,22,000 to INR 7,59,500 ($5000 to $9000). The cost given here is only for the procedure. Final costing will depend on other factors which are explained below.

Top Hospitals for Fontan Procedure in India

Key Factors that can Influence Fontan Procedure Cost in India

Below here is a list of the key factors that can influence the final cost of Fontan procedure in India: 

• Condition of the patient
• The type of hospital one chooses as price depends on the type of hospital
• Medications
• The type of procedure performed
• Additional diagnostic procedure
• The doctor’s expertise.

What is Fontan Procedure? 

The Fontan procedure, commonly referred to as Fontan Kreutzer, is primarily employed in the management of single ventricle heart defects, such as hypoplastic left heart syndrome, tricuspid atresia, and pulmonary atresia, conditions in which the heart possesses only one effective pumping chamber instead of the usual two.

This surgical intervention entails redirecting blood flow within the heart to circumvent the impaired ventricle, thereby facilitating the delivery of oxygenated blood to the body. Typically conducted on pediatric or young adult patients, the Fontan procedure seeks to enhance the quality of life for individuals affected by these conditions, enabling them to engage in a more typical and active lifestyle.

Who is the Right candidate for The Fontan procedure? 

Children aged 2 to 15, particularly those between 3 and 5 years old, who are diagnosed with a single ventricle condition may be suitable candidates for the Fontan heart procedure in India. However, this procedure is not universally applicable. The physician responsible for your child’s care will assess their eligibility for the Fontan procedure. Key factors include the strength of their functional ventricle, which must be capable of effective pumping, and the condition of their lungs, which should be adequate to accommodate passive blood flow.

Prior to undergoing the Fontan heart procedure, it is likely that your child will need to have had at least one of the following procedures:

– Norwood Procedure

– Glenn Procedure

– Blalock-Taussig-Thomas (BTT) shunt

– Pulmonary Artery Band.

What are the Different Types of Fontan Procedures?

Fontan procedures in India can be executed through various techniques, primarily determined by the specific type of cardiac defect present. The following three methods are designed to facilitate the restoration of blood flow:

1. Classic Fontan Procedure: This original technique redirects oxygen-poor blood from the lower body directly to the pulmonary artery. It involves establishing a connection between the inferior vena cava (IVC) and the pulmonary artery, enabling blood to reach the lungs for oxygenation.
2. Atriopulmonary Connection (APC) Fontan: This variation utilizes the atrial wall to create a connection between the inferior vena cava (IVC) and the pulmonary artery. This method is particularly useful when the size or anatomical structure of the IVC does not permit a direct connection.
3. Total Cavopulmonary Connection (TCPC) Fontan: This technique connects both the superior and inferior vena cavae directly to the pulmonary arteries. The TCPC Fontan can be further categorized into different types based on the specific connections established, such as lateral tunnel and extracardiac conduit.
4. Hemi-Fontan Procedure: Serving as an intermediary step between the Glenn procedure and the completion of the Fontan, this method connects the superior vena cava (SVC) directly to the pulmonary arteries, while the IVC continues to supply blood to the heart. The final Fontan completion is typically performed at a later date.
5. Bicaval Fontan: This procedure connects both the superior and inferior vena cava to the pulmonary arteries without employing an intra-atrial baffle, aiming to enhance the efficiency of blood flow.
6. Fenestrated Fontan: In certain instances, a small opening (fenestration) is deliberately created in the Fontan circulation to permit a controlled volume of blood to return to the heart. This can alleviate pressure and minimize complications, particularly during the early postoperative phase. The fenestration may be closed later if the patient’s condition improves.

The decision to perform the Fontan procedure relies on the patient’s unique body structure, general health, and particular heart issues. Cardiac surgeons and medical teams will evaluate each patient’s case to determine the most suitable approach.

What are the Type of Test Done Before The Fontan Procedure? 

Once a child’s healthcare provider identifies them as a suitable candidate for the Fontan procedure, a series of tests will be conducted, which may encompass:

• Transthoracic echocardiogram (TTE)
• Electrocardiogram (EKG)
• Heart catheterization
• Pulmonary assessment (evaluating your child’s respiratory function and oxygen saturation)
• Imaging techniques, such as CT or MRI, if necessary.

How is The Procedure Performed? 

Prior to the start of the surgical procedure, the patient will receive general anesthesia to ensure they are unconscious throughout the operation. The entire process generally lasts between four to six hours. In the initial phase of the surgery, blood that is low in oxygen is rerouted to the lungs by severing the connections from the pulmonary arteries. 

Subsequently, a shunt is established by detaching the superior vena cava from the heart and redirecting it into the pulmonary arteries, while the inferior vena cava remains undisturbed. In the second phase, the oxygen-depleted blood from the inferior vena cava is directed to the lungs. Following the completion of the surgery, the patient will be transferred to the intensive care unit (ICU) for meticulous observation. It is common for patients to have a breathing tube in place for several days to assist with respiration, as well as a catheter in the bladder to facilitate urine drainage.

What Are the Risks Associated with the Fontan Procedure?

• Narrowing of the pulmonary arteries leads to high blood pressure in the lungs.
• When the atrioventricular valve leaks, blood can flow back from the atrium to the ventricle.
• The tube or duct placed during surgery may also have narrowing.
• Blood clots and embolisms can form, particularly causing pulmonary embolism.
• High pressure in the inferior vena cava can result in liver issues like cirrhosis, liver failure, liver cancer, and increased pressure in the liver’s blood vessels.
• Symptoms of heart failure include reduced blood flow, heart tissue death, and difficulty with intense exercise.
• Fluid buildup around the lungs, known as pleural effusion, can lead to shortness of breath and longer hospital stays.
• Patients may struggle with exercise.
• There might be liver complications, such as scarring of the liver.
• Some patients may need a heart transplant after several years.

Some Healthy Tips You Need to Know After Fontan Procedure

After a Fontan procedure, you can take steps to stay healthy, such as: 

1. Exercise: Engage in regular, moderate exercise to boost your heart health and blood circulation. Light to medium weights and resistance training can help build muscle.  
2. Maintain a healthy weight: Aim for a BMI between 20 and 25.  
3. Practice good dental hygiene: Keeping your mouth clean is important, as bacteria can affect your heart.  
4. Stay hydrated: Drink enough fluids, especially when you’re not feeling well.  
5. Avoid smoking: Healthy lungs are crucial for Fontan circulation, so steer clear of smoking.  

6. Regular checkups: Visit a cardiologist for routine exams, including EKGs, echocardiograms, and lab tests. 

Top Cardiologist in India

• Dr. Ajay Kaul
• Dr. T. S. Kler
• Dr. Sanjay Gupta
• Dr. D. K. Jhamb
• Dr. Naresh Trehan