Occlusion of Fontan fenestrations using the Amplatzer septal occluder

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Abstract

Objective

To evaluate the efficacy and safety of the Amplatzer septal occluder device for occlusion of Fontan fenestrations.

Subjects

Five children aged 5-10 years who had undergone a fenestrated Fontan operation.

Setting

Tertiary paediatric cardiology centre.

Methods

Each patient had right and left heart catheterisation to assess haemodynamic suitability for fenestration closure. Sizing of the defect was achieved with a balloon wedge catheter and transoesphageal echocardiography. Transcatheter occlusion of the fenestration was accomplished using a 4 mm device in three patients, and 5 mm or 9 mm devices in the other two patients. Residual shunting following occlusion was assessed using angiography and echocardiography.

Results

100% occlusion rate of the fenestration was achieved in all patients. No complications or device failures were seen during the three month follow up period.

Conclusion

The Amplatzer septal occluder device is safe, and effectively occludes the Fontan fenestration.

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