Closure of Conduit Fenestration After Extracardiac Fontan Procedure Using Amplatzer Vascular Plug: Comparison with Detachable Coil

Abstract

The objective of this study was to report the outcome of fenestration closure using either an Amplatzer Vascular Plug I or detachable coils in patients undergoing extracardiac Fontan procedure with conduit fenestration. We reviewed the medical records of 23 patients who underwent transcatheter closure of conduit fenestration with the extracardiac Fontan procedure. The median age at fenestration closure was 57 months (range 36 to 98). The median interval between the operation and the procedure was 28 months (range 8 to 68). The Amplatzer Vascular Plug I (AVP) was used in 16 patients, and detachable coils were used in 7 patients. In the coil group, we used 1 coil in 3 patients, 2 coils in patients, and 3 coils in 1 patient, all based on angiographic results. In the AVP group, we used a device that was at least 1 mm larger than the initial fenestration size. No immediate or long-term complications were associated with the procedure or with the closure devices. On final follow-up, 3 of 7 patients (43%) in the coil group had complete closure, and 17 of 17 patients (100%) in the AVP group had complete closure. The AVP showed good results for transcatheter closure of a conduit-type fenestration and was found to perform better than the detachable coil.