Successful transcatheter closure of a Fontan fenestration with a bioabsorbable Biostar occluder.
We report the successful closure of an extracardiac Fontan fenestration with a bio-absorbable device, which may be refenestrated by a transcatheter route when needed, in a 10-year-old boy. The patient presented with cyanosis two years after an extracardiac Fontan operation. Echocardiography revealed a moderate shunt from the Fontan circulation into the systemic circulation with a mean pressure gradient of 3-4 mmHg. Treadmill testing revealed a significant decrease in oxygen saturation (down to the low 50's from a baseline level of 80-85%). Cardiac catheterization revealed normal pressure in the Fontan circuit. A temporary balloon occlusion test showed that the defect was suitable for permanent occlusion. The fenestration was then occluded by a bio-absorbable Biostar (NMT medical, Boston, USA) atrial septal occluder device. The oxygen saturation on room air increased up to 95% after closure.
Department of Pediatric Cardiology, Medicana International Hospital, İstanbul, Turkey. cenapzeybek@yahoo.com
Cenap
C
Zeybek
Ahmet
A
Kırbaş
Yalım
Y
Yalçın
Mehmet Salih
MS
Bilal
D020341:Absorbable Implants; D000792:Angiography; D006328:Cardiac Catheterization; D002648:Child; D003490:Cyanosis; D004417:Dyspnea; D004452:Echocardiography; D018729:Fontan Procedure / Q000009:adverse effects; D006343:Heart Septal Defects / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D055989:Septal Occluder Device / Q000145:classification