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Ann Thorac Surg 1998;65:268
© 1998 The Society of Thoracic Surgeons

Case Reports

Catastrophic Transcatheter Baffle Fenestration for Failing Fontan Physiology

Helena T. Henneveld, MD, Paul Hutter, MD, Francois J. Hitchcock, MD, Narayanswami Sreeram, MD

Department of Cardiology, Wilhelmina Children’s Hospital, Utrecht, the Netherlands

Accepted for publication September 9, 1997.

Dr Hutter, Department of Cardiology, Wilhelmina Children’s Hospital, 3501 CA Utrecht, the Netherlands.

Transcatheter fenestration and balloon dilation of an atrial baffle created from native atrial tissue was attempted in a 15-year-old girl with failing Fontan physiology and protein-losing enteropathy. After transseptal puncture, initial dilations with a 10-mm and 12-mm diameter balloon resulted in an inadequate fenestration, with no significant decrease of right atrial pressure or systemic arterial saturation. Dilation of the fenestration with a 16-mm-diameter balloon produced a tear of the atrial septum and subsequent death. Balloon dilation of native atrial tissue may result in uncontrolled tears of the atrial septum.




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