Fontan fenestration closure with Amplatzer Duct Occluder II device

Abstract

Objectives To evaluate Fontan fenestration closure using the Amplatzer Duct Occluder II device (ADO2). Background Fontan fenestration closure is a well established catheter intervention. A range of occlusion devices developed for other interventions have been utilized. Most of these devices, and especially the most commonly used Amplatzer Septal Occluder, are relatively bulky. The ADO2 is a low profile, flexible, and inexpensive device which seems well suited to the Fontan fenestration. Methods This study details retrospective review of patients undergoing Fontan fenestration closure with an ADO2 device. Outcome measures included procedural success, pre- and post-procedural differences in oxygen saturation and mean pulmonary artery pressure and complications. Results Thirteen patients were eligible for inclusion during the 34 month study period. All procedures were technically successful. There was a significant increase in oxygen saturations (Mean = +12%, P < 0.01) after fenestration closure but no significant change in mean pulmonary artery pressure (Mean = +0.5 mm Hg, P = 0.08). There were no procedural complications. Conclusion Fontan fenestration closure with the ADO2 device is a simple, short, and cost-effective procedure. The ADO2 characteristics recommend it to occlusion of varying sizes and morphologies of Fontan fenestration.