TRANSCATHETER FENESTRATION DILATION AND OR CREATION IN POSTOPERATIVE FONTAN PATIENTS/

In modified Fontan procedures, a surgically created intra-atrial commu nication or baffle fenestration (BF) has been shown to increase cardia c index, reduce right venous pressures, and decrease perioperative and postoperative morbidity(1-8) at the expense of systemic desaturation. Subsequent BF closure can be performed in most patients.(1,9) When BF closure occurs spontaneously, it may lead to hemodynamic deterioratio n associated with elevated right-sided pressures and high systemic oxy gen saturation, low cardiac output, progressive edema and effusions. T herapeutic options for these severely ill patients are few and of high risk (Fontan takedown or heart transplantation).(10) We report the re sults of a transcatheter palliative approach for symptomatic postopera tive Fontan patients with total or virtual BF occlusion.