Three-dimensional intracardiac echocardiography (3D ICE) has gained popularity in interventional cardiology given its improved spatial and temporal imaging in assessing intracardiac anatomy pre- and post-intervention. We describe the use of 3D ICE in the reduction of a Fontan fenestration with an Occlutech atrial flow regulator (AFR) device.
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Occluded Fenestration is Associated with Improved Long-Term Outcomes in Patients Undergoing the Fenestrated Fontan Operation.
J Thorac Cardiovasc Surg
January 2025
Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan. Electronic address:
Objective: The modified Fontan operation, a palliative approach for single ventricular circulation patients, often incorporates a fenestration to facilitate postoperative management. Postoperative fenestration closure is sometimes performed to mitigate potential risks such as low oxygen saturation. However, the benefits and potential risks of this procedure remain under investigation.
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Department of Cardiovascular Surgery, Nagano Children's Hospital, Azumino, Japan.
Background: The discussion of Fontan fenestration is difficult because many institutions have different strategies over time. In our institute, we performed a non-fenestrated Fontan procedure for single-ventricular physiology as our definitive strategy.
Methods: Between August 1999 and December 2007, 72 consecutive patients with single-ventricle physiology underwent extracardiac total cavopulmonary connection without fenestration as our definitive strategy.
Evaluation of the effects of fenestration in Fontan circulation using a lumped parameter model.
J Physiol Sci
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Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Fenestration has been reported to enhance Fontan hemodynamics in several cases of Fontan circulation. However, the indication criteria for fenestration remain under discussion. To assess the effectiveness of fenestration in Fontan circulation, we conducted a theoretical analysis using a computational model of the fenestrated Fontan circulation.
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Department of Pediatrics, Ministry of National Guard Health Affairs, King Abdullah Specialized Children Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
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Division of Cardiothoracic and Vascular Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala India.
Unlabelled: Appearance of a thrombus in the graft intraoperatively during Fontan surgery is not reported and warrants careful evaluation. Our patient was an 18-year-old lady who underwent fenestrated extracardiac Fontan surgery. Intraoperatively, transesophageal echocardiography revealed an echogenic structure inside the conduit.
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