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Fontan pulsátil: Oclusión transcatéter de la arteria pulmonar permeable: Seguimiento a mediano plazo

Keywords: catheterization, fontan-type circuit, occluder device.

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Abstract:

objective: we report the percutaneous closure of the pulmonary artery with residual shunt in patients with fontan type circuit. method: patients aged 9 and 11 years, with sao2 of 88 and 96%, respectively. one of them coursing with headaches and functional class ii. both patients with total cavopulmonary anastomosis and fenestrated extracardiac conduit and permeable pulmonary artery (pulsatile fontan). an amplatzer duct-occluder device was implanted in the pulmonary artery entering from the femoral vein. follow-up by means of clinical examination, imaging, and catetherization was pursued. results: case 1, patency fenestration, qp/qs: 0.7/1. case 2, closed fenestration, qp/qs; 1.3/1. we obtained immediate occlusion with 6/4 and 8/6 devices, respectively; pressure recordings revealed modification of the arterial morphology to biphasic; pulmonary pressure dropped 2 mm hg in the first patient, without alteration in the second case; no changes in sao2 were registered. time of fluoroscopy was 57 and 45 minutes, respectively. follow-up was maintained for 2.8 and 2.3 years, respectively. in patient 1, headaches disappeared and the fenestration was occluded with an amplatzer septal-occluder one year later, raising sao2 to 96%; no complications occurred nor was recanalization of the pulmonary artery needed in either case. conclusions: percutaneous occlusion of patent pulmonary artery in patients with fontan type circuit is a feasible and effective procedure, and avoids overload of the single ventricle.

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