| Transcatheter closure of fenestrations and excluded hepatic veins after fontan: versatility of the Amplatzer device. | |
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MedLine Citation:
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PMID: 10966558 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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J W Moore; K A Murdison; G M Baffa; K Kashow; J D Murphy |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: American heart journal Volume: 140 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 2000 Sep |
Date Detail:
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Created Date: 2000-09-27 Completed Date: 2000-09-27 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 534-40 Citation Subset: AIM; IM |
Affiliation:
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Nemours Cardiac Center, duPont Hospital for Children, Wilmington, Delaware, USA. jwm32@drexel.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Anoxia / etiology, therapy Child Child, Preschool Coronary Thrombosis / prevention & control Female Fontan Procedure / instrumentation* Heart Catheterization / instrumentation*, methods Heart Defects, Congenital / surgery* Hepatic Veins / surgery* Humans Infant Male Postoperative Complications / prevention & control Prosthesis Implantation Stents* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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