What is a Fontan fenestration?
Fenestration closure after a Fontan operation is a procedure to close the hole between your child’s heart and the tunnel that takes oxygen-poor blood from the body to the lungs. The procedure is done in the heart catheterization lab. There is a small risk that your child will have complications from the procedure.
What is the Fontan procedure used for?
Introduction. The Fontan procedure refers to any surgical procedure that leads to systemic flow of venous blood to the lungs without passing through a ventricle. In 1971, Fontan and Baudet (1) described a surgical procedure for repair of tricuspid atresia that built on experimental and clinical research from the 1940s.
When does Fontan fenestration close?
Hypoplastic Left Heart Syndrome Fenestration Closure via Heart Catheterization is necessary is when a large fenestration or hole in the Fontan baffle is closed. It is done during a heart catheterization six to twelve months after the Fontan procedure.
How common is the Fontan procedure?
The worldwide population of patients with Fontan circulation grew to an estimated 50 000 to 70 000 patients in 2018, with 40% of patients >18 years of age.
What is Fontan disease?
Cardiac Center The Fontan operation is a series of three staged reconstructive surgeries in children born with single ventricle disease, a life-threatening condition characterized by a severely underdeveloped ventricle, one of the heart’s two pumping chambers.
What is Fontan pressure?
High systemic venous pressure is the essence of the Fontan paradox where a higher than normal systemic venous pressure is necessary to maintain pulmonary blood flow. In failing Fontan, this systemic venous hypertension is transmitted to the venous and the lymphatic circulation.
What is dehiscence and fenestration?
Fenestration is the condition, in which the bony coverage of the root surface is lost, and the root surface is only covered by the periosteum and gingiva. In such lesions, marginal bone is intact. When this bone defect spreads toward the marginal bone, it is called dehiscence.[1]
What is endoscopic fenestration?
Endoscopic fenestration via a transcortical approach attempts to minimize cerebrospinal fluid drainage into the subdural space, avoiding the development of significant postoperative extra-axial collections, while promoting flow into the basal cisterns.
What are Fontan patients?
The Fontan procedure is done for children who are born with heart problems like hypoplastic left heart syndrome (HLHS), tricuspid atresia, and double outlet right ventricle. Depending on the heart problem, children may need the Norwood procedure and Glenn procedure before the Fontan surgery.
What is Fontan failure?
Late Fontan failure may present insidiously over years. It is a failure of medical management to interpret the absence of overt symptoms or ascites as evidence of optimal haemodynamic status in the functionally univentricular circulation.
What is Ebstein anomaly?
Ebstein anomaly is a rare congenital heart defect in which the tricuspid valve is incorrectly formed and positioned lower than usual in the heart. Atrial septal defect is a hole between the two upper chambers of the heart. About half the people with Ebstein anomaly have an atrial septal defect.
What is a failed Fontan?
The Australian and New Zealand Fontan Registry (ANZFR) defines Fontan failure as the occurrence of death, heart transplant, protein-losing enteropathy (PLE), plastic bronchitis or New York Heart Association (NYHA) Functional class III or IV at follow-up.
What is the purpose of partial fenestration of the Fontan circuit?
Partial fenestration of the Fontan circuit so as to leave an atrial septal defect prevents the adverse effects of rapid rise in venous pressure as it relieves the excessive right atrial pressure in the immediate postoperative period. [1]. Very high venous pressures can cause hypoproteinemia due to protein losing enteropathy.
What happens during a Fontan procedure?
During the Fontan procedure, the surgeon: Disconnects the inferior vena cava (IVC) from the heart and connects it to the pulmonary artery using a conduit (tube). Makes a small hole between the conduit and the right atrium. This hole (or fenestration) lets some blood still flow back to the heart.
Why is there a fenestration in the atrial baffle after a Fontan?
In 90 patients with characteristics placing them at increased risk for a Fontan operation, a fenestration was created in the atrial baffle at the time of the Fontan repair. The rational was to allow a right to left shunt which would maintain cardiac output and limit right atrial pressure in the pres …
What is a fenestration procedure?
Fenestration is the creation of a communicating channel between the false and true lumen, as described later. The patient is prepared for intervention with IV hydration, analgesics, and antihypertensive medications, usually in the ICU. The procedure is done in a fluoroscopy suite with fixed imaging equipment and monitoring.