title: [Pulsatile Fontan: transcatheter closure of patent pulmonary artery. Follow up mid-term].
abstract: OBJECTIVE
  We report the percutaneous closure of the pulmonary artery with residual shunt in patients with Fontan type circuit.
  
  
  METHODS
  Patients aged 9 and 11 years, with SaO2 of 88 and 96%, respectively. One of them coursing with headaches and functional class II. Both patients with total cavopulmonary anastomosis and fenestrated extracardiac conduit and permeable pulmonary artery (pulsatile Fontan). An Amplatzer duct-occluder device was implanted in the pulmonary artery entering from the femoral vein. Follow-up by means of clinical examination, imaging, and catetherization was pursued.
  
  
  RESULTS
  Case 1, patency fenestration, Qp/Qs: 0.7/1. Case 2, closed fenestration, Qp/Qs; 1.3/1. We obtained immediate occlusion with 6/4 and 8/6 devices, respectively; pressure recordings revealed modification of the arterial morphology to biphasic; pulmonary pressure dropped 2 mm Hg in the first patient, without alteration in the second case; no changes in SaO2 were registered. Time of fluoroscopy was 57 and 45 minutes, respectively. Follow-up was maintained for 2.8 and 2.3 years, respectively. In patient 1, headaches disappeared and the fenestration was occluded with an Amplatzer septal-occluder one year later, raising SaO2 to 96%; no complications occurred nor was recanalization of the pulmonary artery needed in either case.
  
  
  CONCLUSIONS
  Percutaneous occlusion of patent pulmonary artery in patients with Fontan type circuit is a feasible and effective procedure, and avoids overload of the single ventricle.
authors.affiliation: Sección de Cardiología Pediátrica del Institute de Cardiología y Cirugía Cardiovascular Fundación Favaloro, Buenos Aires, Argentina. rgamboa@ffavaloro.org
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gamboa
authors.forename: Francisco P
authors.initials: FP
authors.lastname: Mollón
authors.forename: Raúl E
authors.initials: RE
authors.lastname: Ríos Méndez
authors.forename: Raúl O
authors.initials: RO
authors.lastname: Cayré
authors.forename: Mario
authors.initials: M
authors.lastname: Cazzaniga
authors.forename: Graciela M
authors.initials: GM
authors.lastname: Arroyo
authors.forename: Diego F
authors.initials: DF
authors.lastname: Gutiérrez
mesh_terms: D002404:Catheterization; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000379:methods