TY - JOUR
T1 - Transcatheter closure of fenestrations and excluded hepatic veins after fontan
T2 - Versatility of the amplatzer device
AU - Moore, John W.
AU - Murdison, Kenneth A.
AU - Baffa, Gina M.
AU - Kashow, Kathy
AU - Murphy, John D.
PY - 2000
Y1 - 2000
N2 - Background: The aim of this study was to evaluate the Amplatzer septal occluder (ASO) for transcatheter closure of fenestrations and excluded hepatic veins in patients after modified Fontan operations. Residual right-to-left shunts have improved surgical results of the Fontan operation. Shunt closure may eventually be desirable to eliminate hypoxemia and reduce risk of embolic complications. Methods and Results: Ten patients with hypoxemia caused by residual shunts after Fontan procedures were evaluated for closure. After favorable results of test occlusion, all shunts were closed with the use of the ASO. Eight ASOs were used to close fenestrations in 7 patients with 6F transvenous sheaths. Three ASOs were used to close excluded hepatic veins in 3 patients with 6F venous sheaths and transbaffle punctures. Fluoroscopy and transesophageal echocardiography were used to guide device placement. Device placement in all patients was successful. All shunts were closed by angiography after device placement. While breathing room air, systemic oxygen saturation rose from 87.9% ± 3.0% to 96.3% ± 0.9% [P < .001) in the patients. There were no complications of the implant procedures and none noted in outpatient follow-up. Conclusions: This experience suggests that the ASO is safe and effective for closing surgical shunts after Fontan procedures. The ASO design allows closure of excluded hepatic veins and has advantages over other devices in closure of fenestrations.
AB - Background: The aim of this study was to evaluate the Amplatzer septal occluder (ASO) for transcatheter closure of fenestrations and excluded hepatic veins in patients after modified Fontan operations. Residual right-to-left shunts have improved surgical results of the Fontan operation. Shunt closure may eventually be desirable to eliminate hypoxemia and reduce risk of embolic complications. Methods and Results: Ten patients with hypoxemia caused by residual shunts after Fontan procedures were evaluated for closure. After favorable results of test occlusion, all shunts were closed with the use of the ASO. Eight ASOs were used to close fenestrations in 7 patients with 6F transvenous sheaths. Three ASOs were used to close excluded hepatic veins in 3 patients with 6F venous sheaths and transbaffle punctures. Fluoroscopy and transesophageal echocardiography were used to guide device placement. Device placement in all patients was successful. All shunts were closed by angiography after device placement. While breathing room air, systemic oxygen saturation rose from 87.9% ± 3.0% to 96.3% ± 0.9% [P < .001) in the patients. There were no complications of the implant procedures and none noted in outpatient follow-up. Conclusions: This experience suggests that the ASO is safe and effective for closing surgical shunts after Fontan procedures. The ASO design allows closure of excluded hepatic veins and has advantages over other devices in closure of fenestrations.
UR - http://www.scopus.com/inward/record.url?scp=0033835482&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033835482&partnerID=8YFLogxK
U2 - 10.1067/mhj.2000.108517
DO - 10.1067/mhj.2000.108517
M3 - Article
C2 - 10966558
AN - SCOPUS:0033835482
SN - 0002-8703
VL - 140
SP - 534
EP - 540
JO - American Heart Journal
JF - American Heart Journal
IS - 3
ER -