DEPARTMENT OF PEDIATRIC CARDIOLOGY, SHAHEED RAJAIE CARDIOVASCULAR MEDICAL CENTER, VALIASR AVE., TEHRAN, IRAN
We report successful occlusion of the fenestration after total cavopulmonary connection operation due to cyanosis with the Amplatzer septal occluder device. The procedure was satisfactory; arterial oxygen saturation increased markedly and the general condition of the patient improved remarkably. This procedure was done for the first time in the Islamic Republic of Iran. A residual communication or fenestration between systemic and pulmonary venous return is often created during surgical construction of the Fontan circulation. This fenestration may prevent excessive increases in venous pressure in the early postoperative phase, especially in high risk patients. Many of these fenestrations close spontaneously; however some remain open causing persistent arterial desideration and are a potential cause of paradoxical embolism. Subsequent closure of the fenestration using different transcatheter devices, such as double umbrellas and coils has been described. We describe our experience with occlusion of a fenestration using the Amplatzer septal occluder device, a procedure done for the first time in the Islamic Republic of Iran.