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Fontan Physiology & Heart Failure

Innovative approaches to optimize outcomes in single ventricle physiology

Expert Care for Fontan Patients

The Fontan circulation represents a unique physiologic state where the systemic and pulmonary circulations are connected in series without a subpulmonary ventricle. While the Fontan operation has dramatically improved survival for patients with single ventricle physiology, these patients face unique long-term challenges including exercise intolerance, heart failure, arrhythmias, and end-organ complications.

Dr. Charla has dedicated significant research and clinical focus to understanding and optimizing Fontan physiology. His pioneering work on negative pressure ventilation to augment cardiac output in Fontan patients has garnered international recognition and $124K in research funding. He brings comprehensive expertise in managing the complex needs of Fontan patients across the lifespan.

Comprehensive Fontan Care

Fontan Circulation Expertise

Comprehensive understanding of unique hemodynamics and physiology of single ventricle circulation

Novel Therapies

Pioneering research on negative pressure ventilation and other innovative interventions to improve outcomes

Exercise Optimization

Strategies to improve exercise tolerance and cardiac output in Fontan patients

Heart Failure Management

Specialized management of heart failure in CHD including medical optimization and advanced therapies

Arrhythmia Management

Coordinated care for atrial arrhythmias and other rhythm disturbances common in Fontan patients

Surveillance & Monitoring

Protocolized surveillance for Fontan complications including liver disease, protein-losing enteropathy, and thrombosis

Groundbreaking Fontan Research

Negative Pressure Ventilation Research

Dr. Charla is a pioneer in researching negative pressure ventilation (NPV) as a novel therapy to augment pulmonary blood flow and cardiac output in Fontan patients. This groundbreaking work has demonstrated the feasibility and efficacy of non-invasive external ventilation to improve hemodynamics in this unique population.

Research Funding: $124,190
  • • Health Innovations Clinical Research Grant: $24,840
  • • Peter Munk Cardiac Center Innovation Fund: $75,000
  • • SickKids Labatt Heart Center Innovation Fund: $24,350

Key Publication:

Charla P, Karur G, Yamamura K, et al. "Augmentation of the Pulmonary Blood Flow and Cardiac Output by Non-Invasive External Ventilation Late After Fontan Palliation." Heart Journal, July 2020.

Cardiac Output Optimization

Research focus on understanding and optimizing determinants of cardiac output and exercise tolerance in Fontan circulation:

  • Ventilation effects on Fontan physiology
  • Exercise limitations in single ventricle physiology
  • Future innovations to improve functional capacity

Surgical Outcomes Research

Published research on outcomes of staged surgical approaches in patients with double inlet left ventricle and other single ventricle variants.

Presented at international conferences including the International Symposium on Adult Congenital Heart Disease and AAP National Conference.

International Recognition & Speaking

Dr. Charla has been invited to present his Fontan research at leading medical centers worldwide:

"Contemporary Measures to Optimize Cardiac Output and Pulmonary Blood Flow"

36th Annual Conference, Saudi Heart Association – Riyadh, Saudi Arabia (October 2025)

"Ventilation Effects on Fontan Physiology"

Negative Pressure Ventilation (NPV) Summit – Buffalo, Saudi Arabia (October 2025)

"Cardiac Output Determinants and Ventilation Effects on Fontan Physiology"

Cardiology Grand Rounds, St. Christopher's Children's Hospital – Philadelphia, PA (December 2023)

"Exercise and Cardiac Output Limitations in Fontan Circulation: Future Innovations"

Cardiology Grand Rounds, King Faisal Specialty Hospital – Riyadh, Saudi Arabia (February 2022)

Recognition for Fontan Research

ISACHD Young Investigator Award 2018

Awarded by the International Society of Adult Congenital Heart Disease for outstanding research contributions in Fontan physiology and negative pressure ventilation.

Specialized Fontan Care & Research

Expert care for Fontan patients combining clinical excellence with cutting-edge research to optimize outcomes