title: Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava.
abstract: Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC), atrial and visceral situs inversus, left-sided superior vena cava (SVC), and left-sided interrupted inferior vena cava (IVC) with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly.
authors.affiliation: Department of Pediatrics, Division of Cardiology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Pradeepkumar
authors.initials: P
authors.lastname: Charlagorla
authors.affiliation: Department of Pediatrics, Division of Cardiology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Breinholt
keywords: Fenestration; heterotaxy; lateral tunnel Fontan; plastic bronchitis; transjugular approach