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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">97</journal-id>
      <journal-id journal-id-type="index">urn:lsid:arphahub.com:pub:B5033382-9D21-53CE-B630-B4E3A1146D51</journal-id>
      <journal-title-group>
        <journal-title xml:lang="en">Bulgarian Cardiology</journal-title>
        <abbrev-journal-title xml:lang="en">Bulgarian Cardiology</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">1310-7488</issn>
      <issn pub-type="epub">2683-1015</issn>
      <publisher>
        <publisher-name>Bulgarian Society of Cardiology</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.3897/bgcardio.28.e81634</article-id>
      <article-id pub-id-type="publisher-id">81634</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Review Article</subject>
        </subj-group>
        <subj-group subj-group-type="scientific_subject">
          <subject>Hemodynamics (хемодинамика)</subject>
          <subject> Pediatric Cardiology (детска кардиология)</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Hemodynamics after Fontan operation in complex congenital heart defects with univentricular circulation</article-title>
      </title-group>
      <contrib-group content-type="authors">
        <contrib contrib-type="author" corresp="yes">
          <name name-style="western">
            <surname>Levunlieva</surname>
            <given-names>Elisaveta</given-names>
          </name>
          <email xlink:type="simple">levunlieva@gmail.com</email>
          <uri content-type="orcid">https://orcid.org/0000-0002-8703-8022</uri>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
      </contrib-group>
      <aff id="A1">
        <label>1</label>
        <addr-line content-type="verbatim">Clinic of Pediatric Cardiology, National Heart Hospital, Sofia, Bulgaria</addr-line>
        <institution>Clinic of Pediatric Cardiology, National Heart Hospital</institution>
        <addr-line content-type="city">Sofia</addr-line>
        <country>Bulgaria</country>
      </aff>
      <author-notes>
        <fn fn-type="corresp">
          <p>Corresponding author: Elisaveta Levunlieva (<email xlink:type="simple">levunlieva@gmail.com</email>).</p>
        </fn>
        <fn fn-type="edited-by">
          <p>Academic editor: Margarita Tzonzarova</p>
        </fn>
      </author-notes>
      <pub-date pub-type="collection">
        <year>2022</year>
      </pub-date>
      <pub-date pub-type="epub">
        <day>06</day>
        <month>04</month>
        <year>2022</year>
      </pub-date>
      <volume>28</volume>
      <issue>1</issue>
      <fpage>24</fpage>
      <lpage>33</lpage>
      <uri content-type="arpha" xlink:href="http://openbiodiv.net/138E8557-A019-5798-8EA3-6E5947AAF77A">138E8557-A019-5798-8EA3-6E5947AAF77A</uri>
      <history>
        <date date-type="received">
          <day>02</day>
          <month>02</month>
          <year>2022</year>
        </date>
        <date date-type="accepted">
          <day>24</day>
          <month>02</month>
          <year>2022</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>Elisaveta Levunlieva</copyright-statement>
        <license license-type="creative-commons-attribution" xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple">
          <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
        </license>
      </permissions>
      <abstract>
        <label>Abstract</label>
        <p>The term “univentricular (single ventricle) heart” refers to many complex congenital heart defects (CHD). The main characteristic of these malformations is the presence of a single anatomical or functional chamber. Normally, the cardiovascular system consists of two circles which are connected in series, i.e. the pulmonary and the systemic circles are driven by a “double pump” – the right and left ventricle. In the univentricular heart, the single ventricle maintains both systemic and pulmonary blood ﬂ ow. The two circulation circles are connected in parallel rather than in series, as is the case in the normal circulation which is driven by two ventricles. The classic Fontan operation was introduced 50 years ago. The Fontan type operations are staged procedures aimed at complete separation of the systemic and venous circulation without a subpulmonary chamber in univentricular CHDs. Originally designed for patients with tricuspid atresia, this concept is currently used i n many complex CHDs in which two ventricular correction is not possible. Although it divides the blood circles and eliminates cyanosis, this physiological correction is associated with signiﬁ cant changes in hemodynamics. The cardiologists and pediatricians should be aware of these peculiarities of the Fontan circulation.</p>
      </abstract>
    </article-meta>
  </front>
</article>
