Nicklaus Children's Hospital Performs Transcatheter Fontan Completion on Two-Year-Old Child

Sept. 9, 2026 —The Nicklaus Children's Hospital Heart Institute has successfully performed one of the first Fontan procedures in the United States utilizing a transcatheter-based approach on a child, marking an important advancement in care for children born with complex congenital heart disease.

In this novel procedure, the team used a catheter-based approach, rather than open-heart surgery, to guide specialized equipment through a blood vessel to complete the child's Fontan circulation. The child, a 2-year-old born with double-outlet right ventricle, is recovering well and has returned home.

Transcatheter Fontan Completion

For children who are candidates for the catheter-based approach, the procedure offers the advantage of no incisions, a shorter hospital stay and a faster recovery compared with traditional surgery.

The procedure was led by Dr. Shyam Sathanandam, chief of cardiovascular medicine at Nicklaus Children's Hospital, co-director of the Nicklaus Children's Heart Institute and clinical professor at FIU Herbert Wertheim College of Medicine, in collaboration with Dr. David Kalfa, chief of cardiovascular surgery and professor and researcher at FIU Herbert Wertheim College of Medicine. Together, the interventional cardiology team and cardiovascular surgery team came together to carefully plan the procedure in the ongoing effort to offer less invasive approaches to care for children with congenital heart defects.

The Fontan procedure, which is traditionally the final planned stage in a series of operations for a child born with a single-ventricle heart defect, is designed to reroute the blood flow so that blood returning from the body goes directly to the lungs, without needing to be pumped there by a ventricle. In a single-ventricle heart defect, only one of the heart's two pumping chambers can effectively support circulation. The Fontan completion directs oxygen-poor blood returning from the lower body to the lungs without first passing through a pumping chamber of the heart. The prior surgeries prepare the heart for the final step.

"This achievement reflects an extraordinary level of collaboration and coordination between our surgical and interventional cardiology team," said Dr. Sathanandam. "It demonstrates what is possible when clinical expertise, innovation and teamwork come together to expand treatment options for children with the most complex heart conditions."

The Nicklaus Children's Heart Institute provides comprehensive care for infants, children and adults with congenital and acquired heart conditions. Its multidisciplinary specialists offer cardiac imaging, interventional cardiology, electrophysiology, cardiovascular surgery, critical care and long-term follow-up, with treatment plans tailored to each patient's needs. The Heart Institute provides access to consultations and follow up care to pediatric cardiac specialists in more than 13 locations spanning Miami-Dade, Broward, Palm Beach and Martin counties.

For more information visit nicklauschildrens.org/Heart