Percutaneous management of cyanosis in Fontan patients using Amplatzer occluders

Mašura, Jozef; Borodacova, Lucia; Tittel, Peter; Berden, Pavel; Podnar, Tomaž

doi:10.1002/ccd.21540

Cited by 33 publications

(25 citation statements)

References 18 publications

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“…Numerous reports have described successful catheter therapy for this problem with use of a variety of occluders, coils, and covered stents [77][78][79][80][81][82] ; the reader is referred to these articles for technical details.…”

Section: Fontan Baffle Leaksmentioning

confidence: 99%

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Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease

Feltes¹,

Bacha

Beekman³

et al. 2011

Circulation

721

571

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Section: Fontan Baffle Leaksmentioning

confidence: 99%

“…Szá-mos beszámolóban leírták a probléma sikeres katéteres kezelését, amelynek során számos, különböző occludert, coilt és fedett stentet használtak; [77][78][79][80][81][82] a technikai részletekkel kapcsolatban utalunk ezekre a cikkekre.…”

Section: Kamrai Septumdefektusokunclassified

Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease

Feltes¹,

Bacha

Beekman³

et al. 2011

Circulation

721

571

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“…Location, size, and type of fenestrations vary widely. Consequently, numerous devices have been used for fenestration closure, including Gianturco coils [14], detachable coils [20], Raskind duct occluders [13], Clamshell devices [4], CardioSeal devices [17], Amplatzer septal occluder [15,16,22], Amplatzer duct occluder [18], AngelWings devices [19], and covered stents [21]. Choice of device to close a fenestration is guided by several factors, including the type of Fontan circulation (intracardiac versus extracardiac), size and location, geometry of the fenestration, likelihood of placing a long sheath in the systemic atrium, ease of availability and atrial size [21].…”

Section: Discussionmentioning

confidence: 99%

“…The majority of patients had an extracardiac Fontan conduit (n ¼ 63) with only five (n ¼ 5) having lateral tunnel intracardiac conduits. The median size of the fenestration was 5.0 mm (range: 4-6) in a 20 mm (range [14][15][16][17][18][19][20][21][22] conduit. Patients were divided into two groups: The aim in the first group (n ¼ 50) was to obtain complete closure of the fenestration.…”

Section: Methods Patientsmentioning

confidence: 98%

“…Persistent cyanosis may lead to decreased exercise tolerance and a risk of paradoxical embolic events if spontaneous closure of the fenestration does not occur [5][6][7][8][9][10]. In addition to the use of surgically placed abdominal snares [11,12], a variety of transcatheter devices have been used for fenestration closure [1,[13][14][15][16][17][18][19][20][21][22]. However, most of these devices lack desirable criteria such as ease of deployment, low profile with minimal material, nonthrombogenicity and a perfect closure rate.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous management of a Fontan fenestration: In search for the ideal restriction—occlusion device

Boshoff

Brown

DeGiovanni

et al. 2009

Cathet Cardio Intervent

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Objective: Most devices devices available for percutaneous closure of Fontan fenestrations tend to be bulky. The aim of this study was to evaluate a low profile custom made device and assess its efficacy and safety. Patients and Methods: A 15 mm PFO star was used as the basis. The following modifications were made: removal of the left disc to reduce thrombogenicity in the left atrium, increase the length of the LA legs from 2 by 15 mm to 3 by 20 mm to prevent dislodgement and later adding a pivot between the left and right umbrella. A partial occluder was made by removing two opposite quadrants from the proximal disk. Results: Device deployment was possible in 93% (63 of 68) patients. In five patients, the device could not be deployed and an alternative device was used. In 45 patients complete closure of the fenestration was obtained and saturations increased from 84% 6 4% to 95% 6 2% (P < 001). In 18 high risk patients with suboptimal Fontan circulation, a modified device was used to effect partial occlusion: saturations increased from 79% 6 7% to 90% 6 4% (P < 0.001); a residual shunt persisted in most patients for several months. No thrombotic events were recorded during follow-up. Conclusions: The modified PFO star device can safely be deployed in Fontan patients to occlude or restrict flow through a fenestration. It has a low profile with minimal foreign material, is non-obstructive and minimally thrombogenic. V C 2009 Wiley-Liss, Inc.

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Percutaneous embolization of a giant collateral vessel originating from the azygos vein via the inferior vena cava

Witzke

Bhatt

Inglessis

2013

Cathet Cardio Intervent

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We present the case of a 45-year-old man with univentricular heart, small outlet chamber, and L-transposition of the great vessels. As an infant, the patient underwent multiple palliative surgical interventions. He presented with worsening dyspnea and fatigue and was found to have systemic oxygen saturation of 85% on 2 L of oxygen by nasal cannula, whereas he had chronically remained between 90 and 95% throughout most of adulthood. There was no evidence of significant valvular regurgitation or stenosis, nor was there an overt intracardiac shunt by echocardiography. Cardiac CT and cardiac MRI revealed a large serpiginous systemic to pulmonary venovenous collateral located behind the left atrium. The collateral drained into the lower right pulmonary vein as it entered the left atrium. The tributary veins to the "giant" collateral were determined by these images modalities. The patient underwent a percutaneous embolization of this giant venovenous collateral via a remnant supracardinal vein originating from the infrarenal inferior vena cava using two Amplatzer Vascular Plug II. Immediately after the procedure the patient's oxygen saturation increased to 90% on room air at rest. At 2 months follow-up the patient had a marked clinical improvement with oxygen saturation as high as 95% on room air while walking. Our case illustrates a successful embolization of a giant collateral via an embryological venous remnant connecting the IVC to the azygos system.

show abstract

Percutaneous management of cyanosis in Fontan patients using Amplatzer occluders

Cited by 33 publications

References 18 publications

Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease

Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease

Percutaneous management of a Fontan fenestration: In search for the ideal restriction—occlusion device

Percutaneous embolization of a giant collateral vessel originating from the azygos vein via the inferior vena cava

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