Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-23T08:43:33.633Z Has data issue: false hasContentIssue false
  • English
  • Français

Creation of a defined and stable Fontan fenestration with the new Occlutech Atrial Flow Regulator (AFR®)

Part of: Interventional Cardiology Functionally Univentricular Heart

Published online by Cambridge University Press:  04 July 2018

Anja Lehner ,
Ingram Schulze-Neick  and
Nikolaus A. Haas
Anja Lehner*
Affiliation:
Department for Pediatric Cardiology and Intensive Care, Ludwig Maximilians University (LMU), Klinikum der Universität München (KUM), Munich, Germany
Ingram Schulze-Neick
Affiliation:
Department for Pediatric Cardiology and Intensive Care, Ludwig Maximilians University (LMU), Klinikum der Universität München (KUM), Munich, Germany
Nikolaus A. Haas
Affiliation:
Department for Pediatric Cardiology and Intensive Care, Ludwig Maximilians University (LMU), Klinikum der Universität München (KUM), Munich, Germany
*
Author for correspondence: A. Lehner, Department for Pediatric Cardiology and Intensive Care, Ludwig Maximilians University (LMU), Klinikum der Universität München (KUM), Marchioninistrasse 15, D-81377 Munich, Germany. Tel: +49 89 4400 73941; Fax: +49 89 4400 73943; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

This report describes the first clinical experience with the new Occlutech Atrial Flow Regulator (AFR®) device for implementation of a late Fontan fenestration. The AFR® device secured a defined diameter of the fenestration without spontaneous re-occlusion of this extra-anatomic perforation. This ensured a permanent clinical improvement of our failing Fontan patient.

Keywords

Fontan circulationtransseptal punctureCHDnew devices (in general)paediatric interventionpulmonary hypertension
Type
Brief Report
Information
Cardiology in the Young , Volume 28 , Issue 8 , August 2018 , pp. 1062 - 1066
Check for updates
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Cite this article: Lehner A, Schulze-Neick I, Haas NA. (2018) Creation of a defined and stable Fontan Fenestration with the new Atrial Flow Regulator (AFR®). Cardiology in the Young28: 1062–1066. doi: 10.1017/S1047951118000720

References

1. Lammers, AE, Derrick, G, Haworth, SG, Bonhoeffer, P, Yates, R. Efficacy and long-term patency of fenestrated amplatzer devices in children. Catheter Cardiovasc Interv 2007; 70: 578–584.Google Scholar
2. Mehta, C, Jones, T, De Giovanni, JV. Percutaneous transcatheter communication between the pulmonary artery and atrium following an extra-cardiac Fontan: an alternative approach to fenestration avoiding conduit perforation. Catheter Cardiovasc Interv 2008; 71: 936–939.Google Scholar
3. Haas, NA, Happel, CM, Soetemann, DB, et al. Optimal septum alignment of the Figulla Flex occluder to the atrial septum in patients with secundum atrial septal defects. EuroIntervention 2016; 11: 1153–1160.Google Scholar
4. Haas, NA, Soetemann, DB, Ates, I, et al. Closure of secundum atrial septal defects by using the Occlutech Occluder devices in more than 1300 patients: the IRFACODE project: a retrospective case series. Catheter Cardiovasc Interv 2016; 88: 571–581.Google Scholar
5. Lemler, MS, Scott, WA, Leonard, SR, Stromberg, D, Ramaciotti, C. Fenestration improves clinical outcome of the Fontan procedure: a prospective, randomized study. Circulation 2002; 105: 207–212.Google Scholar
6. Ono, M, Boethig, D, Goerler, H, Lange, M, Westhoff-Bleck, M, Breymann, T. Clinical outcome of patients 20 years after Fontan operation – effect of fenestration on late morbidity. Eur J Cardiothorac Surg 2006; 30: 923–929.CrossRefGoogle ScholarPubMed
7. Kreutzer, J, Lock, JE, Jonas, RA, Keane, JF. Transcatheter fenestration dilation and/or creation in postoperative Fontan patients. Am J Cardiol 1997; 79: 228–232.Google Scholar
8. Reinhardt, Z, De Giovanni, J, Stickley, J, et al. Catheter interventions in the staged management of hypoplastic left heart syndrome. Cardiol Young 2014; 24: 212–219.CrossRefGoogle ScholarPubMed
9. Casadonte, JR, Wax, DF, Gossett, JG. Extracardiac Fontan fenestration using the SafeSept transseptal guidewire and snare-controlled diabolo-shaped covered-stent placement. Catheter Cardiovasc Interv 2016; 87: 426–431.Google Scholar
10. Rupp, S, Schieke, C, Kerst, G, et al. Creation of a transcatheter fenestration in children with failure of Fontan circulation: focus on extracardiac conduit connection. Catheter Cardiovasc Interv 2015; 86: 1189–1194.Google Scholar
11. Bar-Cohen, Y, Perry, SB, Keane, JF, Lock, JE. Use of stents to maintain atrial defects and Fontan fenestrations in congenital heart disease. J Interv Cardiol 2005; 18: 111–118.Google Scholar
12. Kenny, D, McMahon, C, Walsh, KP. Transhepatic approach for extracardiac inferior cavopulmonary connection stent fenestration. Congenit Heart Dis 2011; 6: 276–279.CrossRefGoogle ScholarPubMed
13. Vyas, H, Driscoll, DJ, Cabalka, AK, Cetta, F, Hagler, DJ. Results of transcatheter Fontan fenestration to treat protein losing enteropathy. Catheter Cardiovasc Interv 2007; 69: 584–589.Google Scholar
14. Kretschmar, O, Sglimbea, A, Corti, R, Knirsch, W. Shunt reduction with a fenestrated Amplatzer device. Catheter Cardiovasc Interv 2010; 76: 564–571.Google Scholar