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
Gamboa, Ricardo; Mollón, Francisco P; Ríos Méndez, Raúl E; Cayré, Raúl O; Cazzaniga, Mario; Arroyo, Graciela M; Gutiérrez, Diego F.
Arch. cardiol. Méx
; 78(3): 293-298, jul.-sept. 2008.
Artículo
en Español
| LILACS | ID: lil-566659
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.
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BR1.1
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