Transcatheter closure of Fontan fenestrations using the Amplatzer septal occluder: Initial experience and follow-up

We have recently used the Amplatzer septal occluder to close Fontan fenestr ations. Between June 1998 and December 1999, 13 patients underwent transcat heter occlusion of their Fontan fenestrations. systemic blood flow decrease d significantly without a concomitant decrease in pulmonary blood flow. All residual shunts detectable by oximetry were at sites separate from those i nto which occlusion devices were implanted. One patient developed severe tr icuspid regurgitation following the procedure requiring surgical removal of the device. At the last follow-up, all patients were doing well clinically . There were no shunts detectable through or around the devices by echocard iography. Our experience indicates that the location of the fenestration wi thin the Fontan baffle is critical to avoiding device interference with oth er intracardiac structures. The Amplatzer septal occluder offers an effecti ve means of transcatheter closure of Fontan baffle fenestrations. Although more experience is needed, our current follow-up data suggest that long-ter m outcomes will be favorable. Cathet. Cardiovasc. Intervent. 51:301-304, 20 00. (C) 2000 Wiley-Liss, Inc.