Fontan pulsátil: oclusión transcatéter de la arteria pulmonar permeable. Seguimiento a mediano plazo / Pulsatile Fontan: transcatheter closure of patent pulmonary artery. Follow up mid-term
Arch. cardiol. Méx
; 78(3): 293-298, jul.-sept. 2008.
Article
in Es
| LILACS
| ID: lil-566659
Responsible library:
BR1.1
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.
Full text:
1
Index:
LILACS
Main subject:
Pulmonary Artery
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Child
/
Female
/
Humans
/
Male
Language:
Es
Journal:
Arch. cardiol. Méx
Journal subject:
CARDIOLOGIA
Year:
2008
Type:
Article