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Percutaneous fenestration closure with problematic residual native atrial septum
Abraham Rothman1, William N Evans, Gary A Mayman
1Children's Heart Center Las Vegas and Department of Pediatrics, University of Nevada School of Medicine, Las Vegas, Nevada 89109, USA. rothman@childrensheartcenter.com
Summary
Closing Fontan fenestrations can involve residual native atrial septum, creating an intermediate chamber. This study explored three distinct methods for closing these specific fenestrations in pediatric cardiac patients.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Interventional Cardiology
Background:
- Fontan fenestrations are surgically created or naturally occurring openings between the atria in patients with single ventricle physiology.
- Closure of these fenestrations is a common procedure to improve cardiac function.
- Residual native atrial septum presents a unique challenge during fenestration closure.
Observation:
- Twenty patients undergoing cardiac catheterization for fenestration closure were analyzed.
- Three of these patients exhibited a residual native atrial septum.
- This septum created an additional intermediate chamber on the pulmonary venous side of the fenestration.
Findings:
- Three distinct closure methods were employed for these challenging fenestrations.
- The study details the techniques used to address the presence of the intermediate chamber.
- Effectiveness and outcomes of each method were evaluated in this specific subgroup.
Implications:
- Understanding these anatomical variations is crucial for successful fenestration closure.
- The findings may inform procedural choices for similar complex cases.
- Improved closure techniques can lead to better long-term outcomes for Fontan patients.