Percutaneous Fontan by inferior vena cava banding and subsequent creation of an intraatrial stent-conduit: a clinical renaissance of a less invasive approach?

INTRODUCTION

Although first performed several years ago, percutaneous total cavopulmonary connection has not yet become a widely adopted procedure in patients with univentricular circulation.

METHODS AND

OBJECTIVES

We describe a case involving a novel, modified technique for the percutaneous completion of the Fontan circulation using covered stents in a 12 kg patient.

RESULTS

The transcatheter Fontan completion was successfully performed. Minimal surgical preparation included banding of the inferior vena cava during the preceding superior cavopulmonary connection. Using needle puncture to create the anastomosis and implanting covered stents, a total cavopulmonary connection with an intra-atrial tunnel was established. The patient recovered uneventfully.

CONCLUSION

Percutaneous total cavopulmonary connection is feasible and may represent a less invasive alternative for selected patients. However, data on this approach are currently very limited, and further studies are urgently needed.