Transcatheter Interventions in Adults With Fontan Palliation

Circ Cardiovasc Interv. 2024 Dec;17(12):e014699. doi: 10.1161/CIRCINTERVENTIONS.124.014699. Epub 2024 Nov 25.

Abstract

The Fontan circuit is associated with chronically elevated systemic venous pressures and decreased cardiac output, often leading to circuit failure. Managing Fontan circuit failure is complex and requires multiple therapeutic options. Transcatheter interventions have emerged as a reliable approach. They can alleviate obstructions and improve cyanosis by enhancing pulmonary blood flow and oxygen saturation. These procedures can also increase cardiac output and reduce systemic venous pressure, contributing to patient stabilization. In addition, they help mitigate volume overload and decrease the risk of bleeding during heart or combined heart and liver transplants. In recent years, percutaneous interventions have rapidly evolved and become a key therapeutic option for addressing various aspects of Fontan circuit failure. These interventions should be considered integral to the management strategy for this specific patient population.

Keywords: Fontan procedure; adults; cardiac output; heart disease; venous pressure.

Publication types

  • Review

MeSH terms

  • Adult
  • Cardiac Catheterization* / adverse effects
  • Fontan Procedure* / adverse effects
  • Heart Defects, Congenital* / physiopathology
  • Heart Defects, Congenital* / therapy
  • Hemodynamics
  • Humans
  • Pulmonary Circulation
  • Recovery of Function
  • Risk Factors
  • Treatment Outcome