Recanalization of a thrombosed atrial flow regulator in a failing Fontan did not improve clinical status, leading to heart transplantation after 1 month.
Percutaneous recanalization and stenting of a thrombosed atrial flow regulator is a feasible bailout strategy for failing Fontan patients, serving as an effective bridge to heart transplantation.
Tasa de eventos absoluta: 0% vs 0%
ABSTRACT We report the case of a 10‐year‐old boy (41 kg, 133 cm) with hypoplastic left heart syndrome (mitral and aortic atresia), who underwent staged palliation: Norwood‐Sano at 6 days, Glenn at 7 months, and Fontan completion at 3 years using a 16 mm non‐fenestrated extracardiac Gore‐Tex conduit. By age 8, he developed Fontan failure with elevated pressures and protein‐losing enteropathy, refractory to medical management, supportive therapy, and hepatic lymphatic embolization. At age 9, the Fontan conduit was needle‐perforated, dilated with a 7 mm balloon, and a 6 × 5 mm Occlutech atrial flow regulator (AFR) was implanted. Complete AFR thrombosis occurred 4 months later. Recanalization was achieved using an Astato® 30 0.018” wire under carotid protection with 6 mm SpiderFX filters, followed by high‐pressure ballooning and a 9 × 18 mm BeSmooth stent implantation. Despite a patent AFR and optimized therapy, the patient showed no clinical improvement and ultimately underwent successful heart transplantation 1 month later under more favorable conditions.
Haddad et al. (Thu,) reported a other. Recanalization of a thrombosed atrial flow regulator in a failing Fontan did not improve clinical status, leading to heart transplantation after 1 month.