Francis Fontan
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Francis Fontan (2 July 1929 – 14 January 2018) was a French
cardiologist Cardiology () is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular hear ...
and
cardiothoracic surgeon Cardiothoracic surgery is the medical speciality, field of medicine involved in surgery, surgical treatment of organs inside the thoracic cavity — generally treatment of conditions of the heart (heart disease), lungs (pulmonology, lung disease) ...
best known for developing the
Fontan procedure The Fontan procedure or Fontan–Kreutzer procedure is a palliative surgical procedure used in children with univentricular hearts. It involves diverting the venous blood from the inferior vena cava (IVC) and superior vena cava (SVC) to the pulmon ...
, a surgical procedure used to treat some forms of
congenital heart disease A congenital heart defect (CHD), also known as a congenital heart anomaly and congenital heart disease, is a defect in the structure of the heart or great vessels that is present at birth. A congenital heart defect is classed as a cardiovascular ...
.


Early life and education

Fontan was born on 2 July 1929 in Nay, a small town in the French
Pyrenees The Pyrenees (; es, Pirineos ; french: Pyrénées ; ca, Pirineu ; eu, Pirinioak ; oc, Pirenèus ; an, Pirineus) is a mountain range straddling the border of France and Spain. It extends nearly from its union with the Cantabrian Mountains to C ...
. He was the son of
Victor Fontan Victor Fontan (born Pau, France, 18 June 1892, died Saint-Vincent 2 January 1982) was a French cyclist who led the 1929 Tour de France but dropped out after knocking at doors at night to ask for another bicycle. His plight led to a change of r ...
and his wife Jeanne (née Larquey). Fontan's father was a cyclist who was leading the
1929 Tour de France The 1929 Tour de France was the 23rd edition of the Tour de France, taking place from 30 June to 28 July. It consisted of 22 stages over . Nicolas Frantz had won two consecutive Tours, in 1927 and 1928, and was looking for a third. In addition t ...
before his bicycle was damaged in an accident, forcing him to withdraw from the race. At age 17, Fontan entered the Faculty of Medicine at the
University of Bordeaux The University of Bordeaux (French: ''Université de Bordeaux'') is a public university based in Nouvelle-Aquitaine in southwestern France. It has several campuses in the cities and towns of Bordeaux, Dax, Gradignan, Périgueux, Pessac, and Ta ...
before specializing in surgery, and later, paediatric cardiac surgery. During his internship, he was mentored by cardiac surgeon Georges Dubourg. He was affected by the death of a young teenager with
tricuspid atresia Tricuspid atresia is a form of congenital heart disease whereby there is a complete absence of the tricuspid valve. Therefore, there is an absence of right atrioventricular connection. This leads to a hypoplastic (undersized) or absent right ventri ...
, and Dubourg told him that he should use the experience as motivation to research possible treatments for the condition. In tricuspid atresia, the patient does not have a functioning
right ventricle A ventricle is one of two large chambers toward the bottom of the heart that collect and expel blood towards the peripheral beds within the body and lungs. The blood pumped by a ventricle is supplied by an atrium, an adjacent chamber in the upper ...
, so at the time
heart transplant A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease when other medical or surgical treatments have failed. , the most common proce ...
was thought to be the only viable surgical option. Fontan completed a thesis on
extracorporeal circulation An extracorporeal is a medical procedure which is performed outside the body. Extracorporeal devices are the artificial organs that remain outside the body while treating a patient. Extracorporeal devices are useful in hemodialysis and cardiac surg ...
, discussing new technology (such as the heart-lung bypass machine) that allows a patient's blood to be oxygenated through a pump on the outside of the body in situations such as
open heart surgery Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons. It is often used to treat complications of ischemic heart disease (for example, with coronary artery bypass grafting); to corr ...
.


Medical career

Fontan joined the faculty at the University of Bordeaux, where he served as a professor of cardiac surgery for 23 years. With a growing interest in the management of patients with congenital heart disease, Fontan was engaged in research between 1964 and 1966. In the hope of treating patients in whom the flow of blood through the right side of the heart was impaired, Fontan endeavoured to create a shunt between the
vena cava In anatomy, the venae cavae (; singular: vena cava ; ) are two large veins (great vessels) that return deoxygenated blood from the body into the heart. In humans they are the superior vena cava and the inferior vena cava, and both empty into the ...
and the
pulmonary artery A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the ''main pulmonary artery'' or ''pulmonary trunk'' from the heart, and t ...
. His initial attempts in dogs were unsuccessful and all the animals died within a few hours. Despite these failures, Fontan felt like the surgery (which later became known as the
Fontan procedure The Fontan procedure or Fontan–Kreutzer procedure is a palliative surgical procedure used in children with univentricular hearts. It involves diverting the venous blood from the inferior vena cava (IVC) and superior vena cava (SVC) to the pulmon ...
) would work in humans, and when his colleague Pierre Broustet asked his opinion about managing a young woman with tricuspid atresia in 1968, Fontan decided to perform the surgery. The patient experienced some complications after surgery, but she survived and recovered from it. The operation was completed on a second patient in 1970, and after a third case the series was published in the international journal ''
Thorax The thorax or chest is a part of the anatomy of humans, mammals, and other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main divisions of the cre ...
'' in 1971. The technique rapidly grew in popularity, and after several refinements is now used internationally. In addition to his eponymous operation, Fontan is known for having been one of the pioneers of
heart transplantation A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease when other medical or surgical treatments have failed. , the most common procedu ...
in France. In 1986 he founded the European Association for Cardiothoracic Surgery (EACTS), becoming the association's first president. He established the organization after becoming frustrated with other scientific meetings for cardiac surgeons in Europe, where he found that a speaker's nationality carried more weight than his or her scientific work. He said that forming EACTS was his proudest achievement. In 2006, he received the "Grand Prix scientifique" of the Lefoulon-Delalande Foundation. Fontan died on 14 January 2018.


References

{{DEFAULTSORT:Fontan, Francis 1929 births 2018 deaths French cardiologists People from Béarn University of Bordeaux alumni Academic staff of the University of Bordeaux 20th-century French physicians 21st-century French physicians French surgeons French cardiac surgeons 20th-century surgeons