Tags

Type your tag names separated by a space and hit enter

A Simplified Technique for Interventional Extracardiac Fontan.
World J Pediatr Congenit Heart Surg. 2017 01; 8(1):92-98.WJ

Abstract

PURPOSE

We report a simple technique for an interventional extracardiac Fontan (ECF) procedure.

DESCRIPTION

At the preparatory stage along with a bidirectional cavopulmonary connection (BCPC; cardiopulmonary bypass), a short piece of polytetrafluoroethylene (PTFE) tube graft is anastomosed to the inferior surface of the right pulmonary artery. Another longer PTFE graft is anastomosed to the transected inferior vena cava (IVC). A large medial opening in the lower PTFE graft is anastomosed to an atriotomy. These two PTFE tubes are anastomosed with a pericardial patch interposed between them. During the later interventional Fontan procedure, this pericardial patch is perforated using radiofrequency, and a covered stent is positioned entirely within the PTFE tubes, eliminating the window into the common atrium and leaving no intrapulmonary prosthetic material.

EVALUATION

The hemodynamics after the preparatory stage is similar to those following a BCPC, with uninterrupted flow from the IVC to the right atrium. On completion, there is a nonfenestrated Fontan circuit.

CONCLUSION

Our technique of interventional Fontan, anatomically and hemodynamically, mimics a standard ECF procedure.

Authors+Show Affiliations

1 Queensland Paediatric Cardiac Services, Lady Cilento Children's Hospital, Brisbane, Australia. 2 UQ School of Medicine, University of Queensland, Brisbane, Australia. 3 Mater Medical Research Institute, Brisbane, Australia.1 Queensland Paediatric Cardiac Services, Lady Cilento Children's Hospital, Brisbane, Australia. 2 UQ School of Medicine, University of Queensland, Brisbane, Australia. 3 Mater Medical Research Institute, Brisbane, Australia.1 Queensland Paediatric Cardiac Services, Lady Cilento Children's Hospital, Brisbane, Australia. 2 UQ School of Medicine, University of Queensland, Brisbane, Australia. 3 Mater Medical Research Institute, Brisbane, Australia.2 UQ School of Medicine, University of Queensland, Brisbane, Australia. 4 John Hopkins All Children's Hospital, St Petersburg, Florida, USA.1 Queensland Paediatric Cardiac Services, Lady Cilento Children's Hospital, Brisbane, Australia. 2 UQ School of Medicine, University of Queensland, Brisbane, Australia. 3 Mater Medical Research Institute, Brisbane, Australia.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

28033076

Citation

Prabhu, Sudesh, et al. "A Simplified Technique for Interventional Extracardiac Fontan." World Journal for Pediatric & Congenital Heart Surgery, vol. 8, no. 1, 2017, pp. 92-98.
Prabhu S, Anderson B, Ward C, et al. A Simplified Technique for Interventional Extracardiac Fontan. World J Pediatr Congenit Heart Surg. 2017;8(1):92-98.
Prabhu, S., Anderson, B., Ward, C., Karl, T., & Alphonso, N. (2017). A Simplified Technique for Interventional Extracardiac Fontan. World Journal for Pediatric & Congenital Heart Surgery, 8(1), 92-98. https://doi.org/10.1177/2150135116663697
Prabhu S, et al. A Simplified Technique for Interventional Extracardiac Fontan. World J Pediatr Congenit Heart Surg. 2017;8(1):92-98. PubMed PMID: 28033076.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Simplified Technique for Interventional Extracardiac Fontan. AU - Prabhu,Sudesh, AU - Anderson,Ben, AU - Ward,Cameron, AU - Karl,Tom, AU - Alphonso,Nelson, PY - 2016/12/30/entrez PY - 2016/12/30/pubmed PY - 2017/8/10/medline KW - Fontan operation KW - interventional procedure KW - single ventricle physiology SP - 92 EP - 98 JF - World journal for pediatric & congenital heart surgery JO - World J Pediatr Congenit Heart Surg VL - 8 IS - 1 N2 - PURPOSE: We report a simple technique for an interventional extracardiac Fontan (ECF) procedure. DESCRIPTION: At the preparatory stage along with a bidirectional cavopulmonary connection (BCPC; cardiopulmonary bypass), a short piece of polytetrafluoroethylene (PTFE) tube graft is anastomosed to the inferior surface of the right pulmonary artery. Another longer PTFE graft is anastomosed to the transected inferior vena cava (IVC). A large medial opening in the lower PTFE graft is anastomosed to an atriotomy. These two PTFE tubes are anastomosed with a pericardial patch interposed between them. During the later interventional Fontan procedure, this pericardial patch is perforated using radiofrequency, and a covered stent is positioned entirely within the PTFE tubes, eliminating the window into the common atrium and leaving no intrapulmonary prosthetic material. EVALUATION: The hemodynamics after the preparatory stage is similar to those following a BCPC, with uninterrupted flow from the IVC to the right atrium. On completion, there is a nonfenestrated Fontan circuit. CONCLUSION: Our technique of interventional Fontan, anatomically and hemodynamically, mimics a standard ECF procedure. SN - 2150-136X UR - https://www.unboundmedicine.com/medline/citation/28033076/A_Simplified_Technique_for_Interventional_Extracardiac_Fontan_ L2 - http://journals.sagepub.com/doi/full/10.1177/2150135116663697?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -