2021 Volume 37 Issue 2 Pages 106-116
Background: With improved treatment of single ventricle physiology, Fontan-type repaired cases are continuously increasing. After Fontan procedures, patients may have severe complications such as supraventricular tachyarrhythmia or failing Fontan circulation. Trans-catheter puncture and fenestration (TPF) to the Fontan conduit have been used as a catheter treatment to address these complications. Due to the technical challenges of the procedures, there are few reports on the effects of trans-catheter re-interventions and the possible complications.
Methods: We retrospectively reviewed the effects and complications of TPF in 7 cases (a total of 9 procedures) performed from 2010 to 2019 in our hospital.
Results: The indications for catheter treatment were: (1) supraventricular tachyarrhythmia (n=4, with 5 procedures); (2) plastic bronchitis (PB) (n=3); and (3) protein-losing gastroenteropathy (PLE) (n=1). In cases of PB and PLE, stent implantation was added into the percutaneously created fenestration. In 3 out of 4 cases, a decrease in central venous pressure was confirmed. Ablation was successful with an efficient catheter approach in all cases. All 9 TPF procedures were completed without complications.
Conclusions: TPF is a feasible and safe therapeutic option compared to open-heart surgery. Additionally, it has a potential for improving specific complications after Fontan completion.
