CHENNAI (India CSR®): Apollo Children’s Hospitals, Chennai announced a world-first milestone in performing 50 percutaneous Fontan procedures without prior surgical preparation. The milestone reflects increasing clinical experience with a catheter-based approach that provides an alternative to conventional open-heart Fontan surgery in carefully selected children with complex single-ventricle heart disease.
Some children are born with complex heart defects in which only one ventricle can effectively support circulation. The Fontan procedure is the final stage of treatment for many of these children, redirecting blood returning from the lower-half of the body directly to the lungs so that the single functioning ventricle can pump oxygen-rich blood into the body.
The technique, developed and refined by Apollo’s Paediatric Cardiology and Paediatric Cardiothoracic Surgery teams, enables the Fontan pathway to be completed using catheters, wires and stents through the blood vessels, without the need for surgical preparation during an earlier operation.
“Children with single-ventricle heart disease often undergo many major heart operations before the Fontan stage. If the anatomy and haemodynamics are suitable a catheter-based approach may allow us to complete the Fontan pathway without another major open-heart operation. The aim is to reduce the burden of yet another major procedure for a child who has already undergone a major cardiac treatment” said Dr C.S. Muthukumaran, Senior Consultant and Head, Department of Paediatric Cardiology, Apollo Children’s Hospitals, Chennai.
Not every child is suited to the approach. Patient selection requires detailed evaluation of cardiac anatomy and haemodynamics including pulmonary artery anatomy and pressures, ventricular function and venous pathways. Depending on the case, the assessment may include echocardiography, CT imaging and cardiac catheterisation.
“This is not about replacing surgery with a newer technique. It is about bringing paediatric cardiology and cardiac surgery together to decide the best way forward for each child” said Dr Neville A G Solomon, Director, Paediatric Cardiothoracic Services, Apollo Children’s Hospitals. “For some children, surgery will remain the best option, while in carefully selected patients, a catheter-based Fontan may offer another pathway.”
Apollo Children’s Hospitals has performed more than 14,000 catheter-based cardiac interventions in children, reflecting its experience in complex paediatric cardiac care. 50-procedure mark speaks to the increasing experience with the approach. While current evidence demonstrates feasibility and encouraging early outcomes, long-term comparative data are required to understand how percutaneous Fontan outcomes compare with conventional surgical Fontan.
Sindoori Reddy, Director – Strategy, Apollo Hospitals, said, “Every time we rethink how a complex condition can be treated, we expand what is possible for a child and their family. Reaching 50 percutaneous Fontan procedures reflects that approach, offering appropriately selected children a less invasive alternative to another major open-heart surgery. At Apollo, our ambition is to keep expanding that frontier by bringing together clinical expertise, technology and innovation to change what is achievable for our youngest patients.”
The event was attended by Dr. Ilankumaran Kaliamoorthy, Chief Executive Officer, Apollo Hospitals, Chennai Region, and Dr. Sushila Narayanasamy, Unit Head, Apollo Women’s & Children’s Hospitals, Chennai, along with the clinical team.
The approach has evolved through clinical experience and peer-reviewed research. The team’s initial description was published in Progress in Pediatric Cardiology in 2023, followed by a detailed report on the technique and patient selection in JACC: Case Reports in 2024, with further refinement reported in 2025.
The milestone underscores the growing role of catheter-based interventions in the management of complex congenital heart disease, while reinforcing the importance of careful patient selection, multidisciplinary decision-making and ongoing long-term clinical follow-up.
(India CSR®)
