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[Percutaneous management of severe hemoptysis in a patient after fontan surgery]

Katherine Alcalá-Marcos1, Giorgio Gabino-González1, Abraham Flores-Gamero1

  • 1Servicio de Cardiología Perioperatoria - Instituto Nacional Cardiovascular - INCOR EsSalud. Lima, Perú Servicio de Cardiología Perioperatoria - Instituto Nacional Cardiovascular - INCOR EsSalud Lima Perú.

Archivos Peruanos De Cardiologia Y Cirugia Cardiovascular
|December 13, 2023
PubMed

Insights

A patient with complex congenital heart disease experienced severe bleeding after Fontan surgery. Percutaneous closure of aortopulmonary fistulas successfully stopped the hemoptysis, offering a favorable outcome.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Interventional Cardiology

Background:

  • Single ventricle physiology presents complex surgical challenges.
  • The Fontan procedure is a palliative surgery for single ventricle defects.
  • Fenestrated extracardiac Fontan surgery aims to improve outcomes but carries risks.

Observation:

  • A patient with single ventricle, tricuspid atresia, and double outlet left ventricle underwent staged palliation including Glenn and fenestrated extracardiac Fontan surgery.
  • Post-Fontan surgery, the patient developed severe hemoptysis unresponsive to medical therapy.
  • Aortopulmonary fistulas were identified as the source of bleeding.

Findings:

  • Percutaneous closure of aortopulmonary fistulas using coils was technically successful.
  • The intervention led to complete resolution of hemoptysis.
  • No recurrence of bleeding was observed during follow-up.

Implications:

  • Percutaneous closure of aortopulmonary fistulas is an effective treatment for post-Fontan hemoptysis.
  • This minimally invasive approach offers a favorable alternative to surgical reintervention.
  • Successful management of this complication can improve long-term outcomes for Fontan patients.

Keywords:
FistulaFontan ProcedureHemoptysis

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