ReviewWhat have we learnt 50 years after the first Fontan procedure?Gargiulo, Gaetano D.a; Bassareo, Pier P.b; Careddu, Lucioa; Egidy-Assenza, Gabrielea; Angeli, Emanuelaa; Calcaterra, GiuseppecAuthor Information aPediatric Cardiac Surgery and GUCH Unit, University of Bologna, S.Orsola-Malpighi Hospital Bologna, Italy bUniversity College of Dublin, Mater Misericordiae University Hospital and Our Lady's Children's Hospital Crumlin, Dublin, Republic of Ireland cUniversity of Palermo, Palermo, Italy Correspondence to Gaetano D. Gargiulo, PhD, MD, Pediatric Cardiac Surgery and GUCH Unit, University of Bologna, S.Orsola-Malpighi Hospital Bologna, Via Massarenti, 9, Bologna 40138, Italy E-mail: [email protected] Received 12 October, 2019 Revised 15 January, 2020 Accepted 25 January, 2020 Journal of Cardiovascular Medicine: May 2020 - Volume 21 - Issue 5 - p 349-358 doi: 10.2459/JCM.0000000000000951 Buy Metrics Abstract The Fontan procedure is often the only definitive palliative surgical option for patients with a variety of complex CHD sharing in common, a single, dominant ventricle. In recent decades, imaging and therapeutic improvement have played a crucial role in those patients in whom many complications can hamper their life. After 50 years from the first procedure, heart transplantation remains the only definitive treatment for those with a failing Fontan circulation. © 2020 Italian Federation of Cardiology - I.F.C. All rights reserved.