Atrial flow regulator for failing Fontan circulation: an initial European experience

Lucia Manuri, Rita Emanuela Calaciura, Andrea De Zorzi, Lilia Oreto, Massimiliano Raponi, Anja Lehner, Nikolaus Haas, Salvatore Agati

Research output: Contribution to journalArticle

Abstract

Transcatheter creation or enlargement of an atrial septal defect has been used to promote adequate blood flow and mixing in some forms of congenital heart defects or as a relief valve in right or left atrial hypertension, resulting in better cardiac output and/or systemic saturation. We report a case of a 4-year-old male affected by complex congenital heart disease who was admitted for management of severe cyanosis following a staged pericardial fenestrated Fontan procedure. Transoesophageal echocardiogram showed a wide fenestration of 9 mm in size with a severely dilated pericardial Fontan system. To avoid a new surgical procedure and as part of a compassionate use programme, we decided to implant an atrial flow regulator device (4 mm in diameter) with percutaneous approach with the goal of reducing the right-to-left shunt and increasing the pulmonary flow. Preprocedural oxygen saturation was 75%, whereas after 2 months of follow-up, we observed a progressive increase of up to 95% with significant reduction in the pericardial Fontan system dimensions at echocardiography.

Original languageEnglish
Pages (from-to)761-764
Number of pages4
JournalInteractive Cardiovascular and Thoracic Surgery
Volume27
Issue number5
DOIs
Publication statusPublished - Nov 1 2018

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