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Planned reduction in Fontan fenestration size using the Atrial Flow Regulator

Published online by Cambridge University Press:  12 April 2021

E. Oliver Aregullin
Affiliation:
Congenital Heart Center, Helen DeVos Children’s Hospital, Grand Rapids, Michigan, USA
Bennett Samuel
Affiliation:
Congenital Heart Center, Helen DeVos Children’s Hospital, Grand Rapids, Michigan, USA
Joseph Vettukattil*
Affiliation:
Congenital Heart Center, Helen DeVos Children’s Hospital, Grand Rapids, Michigan, USA
*
Author for correspondence: J. Vettukattil, Congenital Heart Center, Helen DeVos Children’s Hospital, 100 Michigan NE, Grand Rapids, Michigan, USA. Tel: +1 616 267 0988; Fax: +1 616 267 1408; Email: joseph.vettukattil@helendevoschildrens.org

Abstract

Fontan fenestration allows right-to-left shunting increasing cardiac output and oxygen delivery. Increased shunting occurs as cardiac function and ventricular end-diastolic pressures improve, potentially decreasing oxygen saturation. Complete closure may result in impaired Fontan haemodynamics and low cardiac output; however, there are no dedicated devices to reduce fenestration size. We describe Fontan fenestration size reduction using the Atrial Flow Regulator.

Type
Brief Report
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Rychik, J, Atz, AM, Celermajer, DS, et al. Evaluation and management of the child and adult with Fontan circulation: a scientific statement from the American Heart Association. Circulation 2019; 140: e234e284.10.1161/CIR.0000000000000696CrossRefGoogle Scholar
Saiki, H, Kuwata, S, Iwamoto, Y, et al. Fenestration in the Fontan circulation as a strategy for chronic cardioprotection. Heart 2018; 105: 12661272.10.1136/heartjnl-2018-314183CrossRefGoogle Scholar
Lemler, MS, Scott, WA, Leonard, SR, Stromberg, D, Ramaciotti, C. Fenestration improves clinical outcome of the Fontan procedure: a prospective, randomized study. Circulation 2002; 105: 207212.CrossRefGoogle ScholarPubMed
Gewillig, M, Boshoff, D. Missing a sub-pulmonary ventricle: the Fontan circulation. In: Voelkel, N, Schranz, D (eds). The Right Ventricle in Health and Disease. Springer, New York, 2014: 135157.Google Scholar
Rupp, S, Schieke, C, Kerst, G, et al. Creation of a transcatheter fenestration in children with failure of Fontan circulation: Focus on extracardiac conduit connection. Catheter Cardiovasc Interv 2015; 86: 11891194.10.1002/ccd.26042CrossRefGoogle ScholarPubMed
Zablah, JE, Morgan, GJ. Use of Occlutech® atrial flow regulator in a single ventricle patient: a 3D view of a successful intervention. Eur Heart J Cardiovasc Imaging 2020; 21: 1151.CrossRefGoogle Scholar
Lehner, A, Schulze-Neick, I, Haas, NA. Creation of a defined and stable Fontan fenestration with the new Occlutech Atrial Flow Regulator (AFR®). Cardiol Young 2018; 28: 10621066.CrossRefGoogle Scholar