Transcatheter Closure of Fenestration after Modified Fontan Operation in Children

Background: fenestration in the modified fontan operation allows right-to-left shunting, which reduces the fontan pathway pressure and improves cardiac output. however, on account of the fact that persistent right-to-left shunting results in cyanosis and paradoxical emboli, fenestration closure is recommended after recovery from the fontan operation.methods: this study recruited 3 patients who underwent the transcatheter closure of the fontan fenestration with the asd-amplatzer because of severe cyanosis and significant intracardiac shunts.results: fenestration closure was performed at a mean age of 8 yr (6-12 yr) and average of 15 months after the fontan operation. aortic o2 saturation increased by an average of 17.6% (9-26%). during more than a two-year period of follow-up (mean: 27 months), two patients had complete occlusion on echocardiography and the other one had a small residual shunt. one of these patients had atrial flutter during the follow-up. conclusion: the transcatheter closure of the fontan fenestration is a safe and feasible technique that is effective in elevating systemic o2 saturation and well-being and confers acceptable growth and development in children