[Effects of transcatheter closure of extracardiac Fontan fenestration by Amplatzer duct or septal occluder in three patients].
OBJECTIVE
The purpose of this study was to report our experiences from the transcatheter closure of patent fenestration after total cavopulmonary connection (TCPC) with an extra cardiac conduit.


METHODS
Three patients (7, 14 and 8 years old) with various forms of functionally univentricular heart lesions received a total cavopulmonary connection with an extra cardiac conduit as a final reconstructive procedure. Transcatheter occlusion of the fenestration was accomplished using a 8/6 mm Amplatzer duct occluder in one patient, and 5 mm or 10 mm Amplatzer septal occluder in the other two patients. Residual shunting following occlusion was assessed using angiography and echocardiography.


RESULTS
Post total cavopulmonary connection with an extra cardiac conduit, diagnostic catheterization revealed normal pressures in the superior vena cava and pulmonary artery without obstruction at the site of the anastomosis. Angiography of the extra cardiac conduit confirmed the communication between the conduit and the atrium in all three patients and patients still suffered from cyanosis and low oxygen saturation. Immediate full occlusion of fenestration was obtained in all patients. Post closure, mean central venous pressure returned to normal accompanied with significantly increased oxygen saturation. Cyanosis was also significantly attenuated. There were no procedural complications or device failures at intra-hospital and during the 3 to 6 months follow up period.


CONCLUSIONS
The Amplatzer septal or duct occluder device is a safe and effective strategy for the Fontan fenestration occlusion.
Li
Shi-guo
SG
Department of Radiology, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China. sgli2000@hotmail.com
Jiang
Shi-liang
SL
Xu
Zhong-ying
ZY
Huang
Lian-jun
LJ
Zhao
Shi-hua
SH
Jin
Jing-lin
JL
Yu
Ji-hong
JH
Xu
Jian-ping
JP
D000293:Adolescent; D021721:Balloon Occlusion / Q000379:methods; D006328:Cardiac Catheterization / Q000379:methods*; D002648:Child; D005260:Female; D018729:Fontan Procedure / Q000379:methods; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery*; D014684:Venae Cavae / Q000601:surgery*