Document Detail


Transcatheter closure of fenestrations and excluded hepatic veins after fontan: versatility of the Amplatzer device.
MedLine Citation:
PMID:  10966558     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J W Moore; K A Murdison; G M Baffa; K Kashow; J D Murphy
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  140     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2000-09-27     Completed Date:  2000-09-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  534-40     Citation Subset:  AIM; IM    
Affiliation:
Nemours Cardiac Center, duPont Hospital for Children, Wilmington, Delaware, USA. jwm32@drexel.edu
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MeSH Terms
Descriptor/Qualifier:
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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