Oclusão percutânea da fenestração no pós-operatório tardio da cirurgia de Fontan

Costa, Rodrigo Nieckel da; Reyes, Roberto Omar O'Connor; Pedra, Simone Rolim Fernandes Fontes; Louzas, Giselle de Montalvão e Alpoim; Silva, Maria Aparecida de Almeida; Rubayo, Eliana Muscalu; Santana, Maria Virgínia Tavares; Chaccur, Paulo; Jatene, Ieda Biscegli; Braga, Sérgio L. N.; Fontes, Valmir F.; Pedra, Carlos Augusto Cardoso

doi:10.1590/s2179-83972011000300016

Cited by 1 publication

(1 citation statement)

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“…In patients with congenital cardiac diseases and univentricular heart that have undergone CPS, postoperative complications are common, such as stenoses of pulmonary branches and of anastomotic sutures, thromboses, persistence of fenestration or of systemic-pulmonary anastomoses, presence of run-off veins, venovenous fistulas, chylothorax, plastic bronchitis, protein-losing enteropathy and chronic liver disease. [11][12][13][14][15] Structural malformations cause increased venous pressure, modifying the complex pathophysiology of the uni-ventricular circulation. In these situations, interventional therapeutic procedures may restore circulatory balance and improve clinical conditions, therefore avoiding or, at least, postponing another surgical intervention.…”

Section: Journal Of Transcatheter Interventionsmentioning

confidence: 99%

Interventional therapeutic procedures in cavopulmonary shunts

Oliveira¹,

Haddad²,

Pavão³

et al. 2018

J Transcat Intervent

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Background Cavopulmonary shunts are the palliative surgeries of choice in congenital heart diseases with the anatomical and pathophysiological defect of univentricular heart. The objective of this study was to report the results of percutaneous procedures in patients with complications following partial or total surgical cavopulmonary shunts. Methods: The procedures were conducted under general anesthesia and continuous monitoring of hemodynamic and respiratory parameters. The accesses used were the femoral vein (Fontan) or the internal jugular vein (Glenn). The devices were those commonly used for treating vascular obstructions, occlusion of venovenous or arteriovenous shunts, and systemic-pulmonary anastomoses. Results: Ten procedures were conducted in ten patients; in that, four Glenn (Group I) and six Fontan (Group II). The mean age in Groups I and II was 86 months and 106 months, and the mean time since surgery was 24 months and 25 months, respectively. Six patients had obstructive lesions and four had venovenous shunts, systemic-pulmonary anastomosis or a fenestrated cavopulmonary tube. In cases with obstructive lesions, there was no residual gradient; after dilation, there was a significant increase or normalization of vessel diameter. In patients with shunts, there was complete occlusion after deployment of the device. In all cases hemodynamic parameters normalized, clinical status improved and there were no complications. Conclusions: Percutaneous procedures are safe and effective to treat obstructive lesions or shunts in patients with a history of cavopulmonary shunt and presenting such complications.

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