Transcatheter closure of fenestration with detachable coils after the Fontan operation.
We report our experience in 13 patients who underwent transcatheter closure of Fontan fenestration with the Cook detachable coils. These patients underwent the extracardiac type Fontan operation with a short conduit fenestration (n=7) or lateral tunnel type with a punch-hole fenestration (n=6). Fenestration closure was done at the mean age of 5.1+/-2.4 yr, average of 32 months after the Fontan operation. We used one to three coils depending on the fenestration type, size, and residual shunt. Aortic oxygen saturations increased by an average of 5.4 (2-9)% and mean pressures in the Fontan circuit increased by an average of 2.1 (0-6) mmHg. During follow-up (median of 23 months), five patients (4 in extracardiac, 1 in lateral tunnel) had complete occlusion of the fenestration on echocardiography. There was no immediate or late complication. Transcatheter closure of fenestration in Fontan operation using the Cook detachable coil is a safe and feasible technique. However, the coil was ineffective for closure of a punch-hole fenestration in the lateral tunnel type operation. In the conduit type fenestration, some modification of fenestration method instead of a short conduit for coil closure or use of new device is necessary to increase complete closure rate.
Kim
Sung Hye
SH
Department of Pediatrics, Samsung Seoul Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kang
I-Seok
IS
Huh
June
J
Lee
Heung Jae
HJ
Yang
Ji-Hyuk
JH
Jun
Tae-Gook
TG
D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D005260:Female; D018729:Fontan Procedure / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D019736:Prostheses and Implants