Clinical Experience of New Adjustable Vessel Occluder

Abstract

A new percutaneously adjustable vessel occluder was developed and successfully applied in 4 patients:three neonates (whose body weight were less than 3kgs) with hypoplastic left heart syndrome (HLHS), and one patient with double outlet right ventricle (DORV) with hypoplastic right ventricle. In the Norwood procedure for HLHS, the occluder was applied around a EPTFE tube employed for systemic-pulmonary shunt to manipulate the pulmonary blood flow volume. It was readjusted on occations during acute postoperative pitied after cardiopulmonary bypass according to changes in pulmonary vascular resistance as the influence of post-perfusion lung. One out of three patients survived the acute postoperative period. In the modified Fontan procedure for DORV, the occluder was placed around the anastomosis between right and left appendages to manipulate the degree of right-to-left shunt for the increment of systemic flow maintaining an acceptable PaO2 level. We conclude that the manipulation of pulmonary or systemic circulation in acute postoperative period can be satisfactorily achieved with this ingenious adjustable vessel occluder, especially in patients who undergo Norwood procedure or fenestrated Fontan procedure.