We have read with great interest the article “Current practice of care for adolescent and adult patients after Fontan surgery in Poland” by Ewa Warchoł-Celińska et al. [1] along with the connected Editorial article by Clift et al. [2]. It is very good to know that an attempt to unify the care of the patients after Fontan surgery has been made in our country. The number of included patients was quite large — 398, taking into consideration that only 6 cardiological centers from Poland participated in the survey. In the records of the Pediatric Outpatient Clinic (not including the Adult Outpatient Clinic) of the Silesian Center of Cardiology Diseases in Zabrze (Poland), there have been 262 patients with single ventricles registered from 2008, and 30 of them had Fontan operation. In the latter group, over time, a significant number of complication occurs, including impairment of ventricular function and heart failure, regurgitation of the atrioventricular valves, protein-losing enteropathy, hepatic failure, progressive cyanosis, thromboembolic complications, development of vascular fistulas in the lung, arrhythmias, etc. Currently, the ultimate treatment for failed Fontan circulation is cardiac transplantation, which is a very complex procedure per se, with very promising results when successful [3]. Clift et al. [2] stated that all specialized centers treating patients after Fontan operation should have a relationship with a cardiac transplant center to be able to assess patients for possible cardiac transplantation. In our Center, to date, 8 such procedures have been performed by dr Szymon Pawlak (publication in preparation).
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