Hostname: page-component-848d4c4894-tn8tq Total loading time: 0 Render date: 2024-06-26T23:18:03.143Z Has data issue: false hasContentIssue false

Restrictive atrial septum after the Fontan procedure

Published online by Cambridge University Press:  15 July 2015

Gemma Penford
Affiliation:
The Heart Unit, Birmingham Children’s Hospital, Birmingham, United Kingdom
Daniel Quandt
Affiliation:
The Heart Unit, Birmingham Children’s Hospital, Birmingham, United Kingdom
Oliver Stumper*
Affiliation:
The Heart Unit, Birmingham Children’s Hospital, Birmingham, United Kingdom
*
Correspondence to: Dr O. Stumper, MD, PhD, The Heart Unit, Birmingham Children’s Hospital, Steelhouse Lane, Birmingham B4 6NH, United Kingdom. Tel: +44 121 333 9442; Fax: +44 121 333 9441; E-mail: oliver.stumper@bch.nhs.uk

Abstract

In this study, three patients presenting with early or late postoperative Fontan complications were identified to suffer from restriction of the native atrial septum. This caused significant obstruction to pulmonary venous return and elevated systemic venous pressure. Dobutamine stress testing was used in one patient to identify this lesion. Transcatheter stenting was performed in the other two patients. Patients improved after relief of the obstruction.

Type
Brief Reports
Copyright
© Cambridge University Press 2015 

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.)

References

1. Gewillig, M, Goldberg, DJ. Failure of the Fontan circulation. Heart Fail Clin 2014; 10: 105116.CrossRefGoogle ScholarPubMed
2. Nemeh, HW, Reddy, S, Walters, HL, Hakimi, M, Ross, RD. Restrictive interatrial communication in hypoplastic left heart syndrome after modified Fontan repair. Ann Thorac Surg 2003; 76: 20892091.CrossRefGoogle ScholarPubMed
3. Padalino, MA, Saiki, Y, Tworetzky, W, del Nido, PJ. Pulmonary venous pathway obstruction from recurrent restriction at atrial septum late after Fontan procedure. J Thorac Cardiovasc Surg 2004; 127: 281283.CrossRefGoogle ScholarPubMed
4. Misumi, Y, Hoashi, T, Kagisaki, K, Ichikawa, H. Advancing cor triatriatum in Fontan circulation. Ann Thorac Surg 2013; 95: 14501452.CrossRefGoogle ScholarPubMed
5. Petko, M, Myung, RJ, Wernovsky, G, et al. Surgical reinterventions following the Fontan procedure. Eur J Cardiothoracic Surg 2003; 24: 255259.CrossRefGoogle ScholarPubMed
6. Schranz, D, Bauer, A, Reich, B, et al. Fifteen-year single center experience with the “giessen hybrid” approach for hypoplastic left heart and variants: current strategies and outcomes. Pediatr Cardiol 2015; 36: 365373.CrossRefGoogle Scholar
7. Moszura, T, Dryżek, P, Góreczny, S, et al. Stent implantation into the interatrial septum in patients with univentricular heart and a secondary restriction of interatrial communication. Kardiol Pol 2011; 69: 11371141.Google Scholar