Effects of Transcatheter Closure of Fontan Fenestration on Exercise Tolerance

摘要

Baffle fenestration is associated with a significantly better outcome in standard and high-risk patients undergoing completion of Fontan. We report the effects of subsequent transcatheter closure of fenestration on exercise capacity and oxygen saturation. Sixteen patients with a mean age of 10.3 years underwent Amplatzer septal occluder (ASO) device transcatheter closure of Fontan fenestration. All had a fenestrated Fontan operation 6 month to 8 years prior to the procedure. A stress test was performed before and after device closure of fenestration in 14 patients (2 patients did not tolerate stress test before the procedure). The fenestrations in all patients were successfully occluded with the use of the Amplatzer device occluder. No complications occurred during or after the procedure. O₂ saturation increased from a mean 85.1 ± 7.89% to 94.5 ± 3.63% (p < 0.01) at rest and from 66.2 ± 12.86% to 87.2 ± 8.64% (p < 0.01) following exercise. Exercise duration has also increased from 8.22 ± 2.74 min to 10.29 ± 1.91 min (p < 0.05). Transcatheter closure of Fontan fenestration increases the duration of exercise capacity and increases O₂ saturation at rest and after exercise.