Transcatheter Fenestration Closure after Fontan Surgery

Abstract

Background: Although several studies have examined patients who have undergone transcatheter fenestration closure, comprehensive evaluations of its long-term outcomes remain scarce. Therefore, this study aimed to evaluate the clinical status of these patients after a long-term follow-up period.
Methods: This cross-sectional analytical study evaluated the records of all children with congenital heart diseases admitted for transcatheter fenestration closure at Rajaie Cardiovascular Medical and Research Center, a tertiary care hospital specializing in congenital heart diseases in Tehran, Iran. We included patients with a history of fenestration following Fontan surgery who required fenestration closure between January 2012 and August 2020. Cardiac function data, such as ejection fraction (EF), pulmonary artery pressure (PAP), and O₂ saturation, were extracted from electronic medical records.
Results: We assessed 26 patients (11 female and 15 male) with a mean age of 13.88±3.73 years. Comparing EF before and after fenestration closure revealed a significant difference (P=0.011), with only 2 patients (7.7%) experiencing a slight reduction (5.0%) in EF. No significant difference was observed in PAP before and after closure (P=0.068), although most patients (n=16, 61.5%) had a postprocedural reduction. Our results demonstrated a significant difference before and after the procedure (P<0.001), with all patients exhibiting increased O₂ saturation after closure.
Conclusion: Our study demonstrated improvements in cardiovascular function and desirable organ function among patients. These findings suggest that transcatheter fenestration closure could serve as a beneficial complementary approach for patients with patent fenestration.