The Lifesaving Impact of Transcatheter Interventions in the Early Post-Fontan Palliation Period.
Pediatr Cardiol
; 45(5): 986-997, 2024 Jun.
Article
en En
| MEDLINE
| ID: mdl-38509208
ABSTRACT
Despite advancements in postoperative outcomes after Fontan surgery, there remains a risk of suboptimal outcomes and significant morbidity in the early postoperative period. Anatomical obstructions in the Fontan pathway can lead to prolonged pleural effusion or ascites, cyanosis, and low cardiac output syndrome (LCOS). Transcatheter interventions offer an alternative to early re-surgery for treating these complications. Over a 13-year period, early catheter angiography, performed within 30 days post-index procedure, was administered to 41 patients, identifying anatomical issues that necessitated re-intervention in 39 cases. This led to transcatheter interventions in 37 (10.4%) of the 344 Fontan surgery patients. The median age was 4.8 years (IQR 4-9.4), and the median weight was 16.5 kg (IQR 15-25.2), with females comprising 51.4% (19/37) of this group. The primary indications for the procedures were persistent pleural effusion or ascites in 27 patients (66%), LCOS in 8 patients (20%), and cyanosis in 6 patients (14%). Among the 37 undergoing transcatheter intervention, 30 were treated solely with this method and discharged, three died in ICU follow-up, and four required early re-surgery. No procedural mortality was observed. Our findings demonstrate that transcatheter interventions, including stent implantation, balloon angioplasty, and fenestration dilation, are safe and effective in the early post-Fontan period. Therefore, they should be considered an integral part of the management strategy for this patient group.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Cateterismo Cardíaco
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Procedimiento de Fontan
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Cardiopatías Congénitas
Límite:
Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Revista:
Pediatr Cardiol
Año:
2024
Tipo del documento:
Article
País de afiliación:
Turquía